Rios Paula, Bailey Helen D, Lacour Brigitte, Valteau-Couanet Dominique, Michon Jean, Bergeron Christophe, Boutroux Hélène, Defachelles Anne-Sophie, Gambart Marion, Sirvent Nicolas, Thebaud Estelle, Ducassou Stéphane, Orsi Laurent, Clavel Jacqueline
CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Inserm, Université Paris-Descartes, Université Sorbonne-Paris-Cité, Paris, France.
RNCE - National Registry of Childhood Cancers- hematopoietic cancers, Villejuif, France.
Cancer Causes Control. 2017 Oct;28(10):1125-1132. doi: 10.1007/s10552-017-0944-5. Epub 2017 Aug 24.
Neuroblastoma (NB) is an embryonic tumor that occurs almost exclusively in infancy and early childhood. While considerable evidence suggests that it may be initiated during embryonic development, the etiology of NB is still unknown. The aim of this study was to explore whether there is an association between maternal use of household pesticides during pregnancy and the risk of NB in the offspring.
We conducted a pooled analysis of two French national-based case-control studies. The mothers of 357 NB cases and 1,783 controls younger than 6 years, frequency-matched by age and gender, responded to a telephone interview that focused on sociodemographic and perinatal characteristics, childhood environment, and life-style. Unconditional logistic regression was used to estimate pooled odds ratios and 95% confidence intervals.
After controlling for matching variables, study of origin, and potential confounders, the maternal use of any type of pesticide during pregnancy was associated with NB (OR 1.5 [95% CI 1.2-1.9]). The most commonly used type of pesticides were insecticides and there was a positive association with their use alone (OR 1.4 [95% CI 1.1-1.9]) or with other pesticides (OR 2.0 [95% CI 1.1-3.4]).
Although there is the potential for recall bias due to the study design, our findings add to the evidence of an association between the household use of pesticides and NB. Until a better study design can be found, our findings add yet another reason why to advise pregnant women to limit pesticide exposure during the periconceptional period.
神经母细胞瘤（NB）是一种几乎仅发生于婴儿期和儿童早期的胚胎性肿瘤。虽然有大量证据表明它可能在胚胎发育期间始发，但NB的病因仍不明。本研究的目的是探讨孕期母亲使用家用杀虫剂与后代患NB风险之间是否存在关联。
我们对两项基于法国全国范围的病例对照研究进行了汇总分析。357例NB病例和1783例6岁以下对照的母亲，按年龄和性别进行频率匹配，她们接受了一次电话访谈，内容集中在社会人口统计学和围产期特征、儿童期环境及生活方式。采用无条件逻辑回归来估计汇总比值比及95%置信区间。
在对匹配变量、研究来源及潜在混杂因素进行控制后，孕期母亲使用任何类型的杀虫剂均与NB相关（比值比1.5 [95%置信区间1.2 - 1.9]）。最常用的杀虫剂类型为杀虫剂，单独使用它们（比值比1.4 [95%置信区间1.1 - 1.9]）或与其他杀虫剂一起使用（比值比2.0 [95%置信区间1.1 - 3.4]）均存在正相关。
尽管由于研究设计存在回忆偏倚的可能性，但我们的研究结果进一步证明了家用杀虫剂的使用与NB之间存在关联。在找到更好的研究设计之前，我们的研究结果为建议孕妇在受孕前后期间限制杀虫剂暴露又增添了一个理由。
