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孕期母亲居住地农药使用情况与儿童恶性脑肿瘤风险:ESCALE和ESTELLE研究(SFCE)的汇总分析

Maternal residential pesticide use during pregnancy and risk of malignant childhood brain tumors: A pooled analysis of the ESCALE and ESTELLE studies (SFCE).

作者信息

Vidart d'Egurbide Bagazgoïtia Nicolas, Bailey Helen D, Orsi Laurent, Lacour Brigitte, Guerrini-Rousseau Léa, Bertozzi Anne-Isabelle, Leblond Pierre, Faure-Conter Cécile, Pellier Isabelle, Freycon Claire, Doz François, Puget Stéphanie, Ducassou Stéphane, Clavel Jacqueline

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. 2018 Feb 1;142(3):489-497. doi: 10.1002/ijc.31073. Epub 2017 Oct 9.

Abstract

Some previous epidemiological studies have suggested that pesticide exposure during pregnancy may have a possible role in the development of childhood brain tumors (CBT). We pooled data from two French national population-based, case-control studies to investigate the association between maternal residential use of pesticides during pregnancy and the risk of CBT. The mothers of 437 CBT cases and 3,102 controls aged under 15 years who resided in France at diagnosis/interview, frequency-matched by age and gender, answered a structured telephone interview conducted by trained interviewers. Unconditional logistic regression was used to estimate pooled odds ratio (OR) and 95% confidence intervals (95% CI). CBT was significantly associated with the maternal home use of pesticides during pregnancy (OR 1.4, 95% CI 1.2-1.8) and, more specifically, with insecticide (OR 1.4, 1.2-1.8). We could not draw any conclusions about herbicides and/or fungicides because few women used them during pregnancy and most of these mothers also used insecticides. Although potential recall bias cannot be excluded, our findings of this pooled analysis support the hypothesis that residential maternal use of pesticides during pregnancy and particularly insecticides may increase the risk of CBT. Future investigations to verify these findings and to explore for CBT subtypes and dose-response are necessary to have a better understanding of the possible role of pesticides in etiology of CBT.

摘要

一些先前的流行病学研究表明,孕期接触杀虫剂可能在儿童脑肿瘤(CBT)的发生发展中发挥作用。我们汇总了两项基于法国全国人口的病例对照研究的数据,以调查孕期母亲在家中使用杀虫剂与CBT风险之间的关联。437例CBT病例和3102例15岁以下对照的母亲在诊断/访谈时居住在法国,按年龄和性别进行频率匹配,回答了由经过培训的访谈员进行的结构化电话访谈。采用无条件逻辑回归来估计汇总比值比(OR)和95%置信区间(95%CI)。CBT与孕期母亲在家中使用杀虫剂显著相关(OR 1.4,95%CI 1.2 - 1.8),更具体地说,与使用杀虫剂相关(OR 1.4,1.2 - 1.8)。由于孕期很少有女性使用除草剂和/或杀菌剂,且这些母亲大多也使用杀虫剂,因此我们无法就除草剂和/或杀菌剂得出任何结论。尽管不能排除潜在的回忆偏倚,但我们这项汇总分析的结果支持这样的假设,即孕期母亲在家中使用杀虫剂,尤其是杀虫剂,可能会增加CBT的风险。未来有必要进行调查以验证这些发现,并探索CBT的亚型和剂量反应,以便更好地了解杀虫剂在CBT病因学中的可能作用。

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