Department of Social and Preventive medicine, University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Ann Epidemiol. 2019 Sep;37:57-63.e3. doi: 10.1016/j.annepidem.2019.07.009. Epub 2019 Jul 12.
We studied whether having an infant with birth defects was associated with the risk of maternal cancer.
We carried out a longitudinal cohort study of 1,214,506 women who delivered infants between 1989 and 2016 in Quebec, Canada. We identified women whose infants had birth defects and followed the mothers over time to identify cancers up to 28 years after delivery. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between birth defects and maternal cancer, adjusted for maternal characteristics.
A total of 36,050 women developed cancer during 19,251,851 person-years of follow-up. Relative to no birth defects, women whose infants had defects did not have an elevated risk of cancer overall (HR 1.03, 95% CI 0.99-1.06). However, associations were present with placental cancer (HR 2.23, 95% CI 1.04-4.77) and lymphoid leukemia (HR 1.61, 95% CI 1.03-2.51). Among specific birth defects, women whose infants had heart (HR 1.12, 95% CI 1.03-1.21) or sensory (HR 1.16, 95% CI 1.04-1.30) defects had a higher risk of cancer.
We found inconsistent evidence of a clinically meaningful association between having an infant with birth defects and the risk of early maternal cancer.
我们研究了婴儿出生缺陷是否与母亲癌症的风险相关。
我们对 1989 年至 2016 年期间在加拿大魁北克省分娩的 1214506 名妇女进行了一项纵向队列研究。我们确定了婴儿有出生缺陷的妇女,并随着时间的推移对母亲进行随访,以确定分娩后 28 年内的癌症。我们使用 Cox 回归估计出生缺陷与母亲癌症之间的风险比(HR)和 95%置信区间(CI),并对母亲特征进行了调整。
共有 36050 名妇女在 19251811 人年的随访中患上了癌症。与无出生缺陷相比,婴儿有缺陷的妇女总体上癌症风险没有升高(HR 1.03,95%CI 0.99-1.06)。然而,与胎盘癌(HR 2.23,95%CI 1.04-4.77)和淋巴白血病(HR 1.61,95%CI 1.03-2.51)存在关联。在特定的出生缺陷中,婴儿有心脏(HR 1.12,95%CI 1.03-1.21)或感觉(HR 1.16,95%CI 1.04-1.30)缺陷的妇女癌症风险更高。
我们发现有婴儿出生缺陷与早期母亲癌症风险之间存在不一致的临床相关关联的证据。