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与妊娠和分娩相关的因素及儿童脑瘤风险:ESTELLE 和 ESCALE 研究(法国 SFCE)。

Factors related to pregnancy and birth and the risk of childhood brain tumours: The ESTELLE and ESCALE studies (SFCE, France).

机构信息

INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France.

RNCE - National Registry of Childhood Cancers, Inserm, Villejuif and CHU de Nancy, France.

出版信息

Int J Cancer. 2017 Apr 15;140(8):1757-1769. doi: 10.1002/ijc.30597. Epub 2017 Jan 31.

Abstract

Little is known of the causes of childhood brain tumors (CBT). The aims of this study were to investigate whether extremes of birth weight were associated with increased risk of CBT and whether maternal preconceptional folic acid supplementation or breastfeeding reduced the risk. In addition, other maternal characteristics and birth related factors were also investigated. We pooled data from two French national population-based case-control studies with similar designs conducted in 2003-2004 and 2010-2011. The mothers of 510 CBT cases (directly recruited from the national childhood cancer register) and 3,102 controls aged under 15 years, frequency matched by age and gender did a telephone interview, which focussed on demographic and perinatal characteristics, and maternal life style habits and reproductive history. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusted for age, sex, study of origin and relevant confounders. No association was found between CBT and birth weight or fetal growth. The use of preconceptional folic acid supplementation was rare (5.3% in cases and 7.8% in controls) and the OR was 0.8 (95% CI 0.5, 1.4). There was no association with breastfeeding, even prolonged (six months or more; OR 1.0, 95% CI 0.8, 1.4). Neither was there any association between CBT and other investigated factors (maternal body mass index, gestational weight gain, congenital abnormality, maternal reproductive history or use of fertility treatments. Although large, this study was underpowered for subtype analyses. Pooling data with other population-based studies may provide further insight into findings by CBT subtypes.

摘要

儿童脑肿瘤(CBT)的病因知之甚少。本研究旨在调查出生体重极端值是否与 CBT 风险增加相关,以及母亲孕前叶酸补充或母乳喂养是否降低风险。此外,还研究了其他母亲特征和与出生相关的因素。我们合并了两项在 2003-2004 年和 2010-2011 年开展的、设计相似的法国全国性基于人群的病例对照研究的数据。510 例 CBT 病例(直接从国家儿童癌症登记处招募)和 3102 例年龄在 15 岁以下的对照的母亲接受了电话访谈,访谈重点是人口统计学和围产期特征以及母亲生活方式习惯和生殖史。使用非条件逻辑回归估计比值比(OR)和 95%置信区间(CI),并根据年龄、性别、研究来源和相关混杂因素进行调整。CBT 与出生体重或胎儿生长之间没有关联。孕前叶酸补充的使用很少(病例组为 5.3%,对照组为 7.8%),OR 为 0.8(95%CI 0.5,1.4)。与母乳喂养也没有关联,即使是延长(六个月或更长时间;OR 1.0,95%CI 0.8,1.4)。CBT 与其他调查因素(母亲体重指数、妊娠体重增加、先天性异常、母亲生殖史或使用生育治疗)之间也没有任何关联。尽管本研究规模较大,但亚组分析的效力不足。与其他基于人群的研究合并数据可能会进一步深入了解 CBT 亚型的发现。

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