University of Helsinki, Children's Hospital, Pediatric Research Center, Helsinki, Finland.
University of Helsinki, Children's Hospital, University of Helsinki and the Finnish Red Cross Blood Service, Helsinki, Finland.
Int J Cancer. 2021 May 1;148(9):2139-2147. doi: 10.1002/ijc.33376. Epub 2020 Nov 11.
Our aim was to study the impact of preterm birth and neonatal therapies on the risk of childhood cancer using a nationwide, registry-based, case-control design. Combining population-based data from Finnish Medical Birth Registry (MBR) and Finnish Cancer Registry, we identified a total of 2029 patients diagnosed with cancer under the age of 20 years and 10 103 age- and sex-matched controls over the years 1996 to 2014. Information on the prenatal and perinatal conditions was obtained from the MBR. Gestational age was categorized into early (<32) and late preterm (32-36) and term (≥37 weeks). Cancer risk among the preterm compared to term neonates was evaluated using conditional logistic regression. We identified 141 cancers among the preterm (20.8% of 678) vs 1888 cancers in the term children (16.5% of 11 454). The risk of any cancer was increased for the preterm (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.06-1.57), especially for the early preterm (OR 1.84, 95% CI 1.16-2.92). The risk of acute myeloid leukemia (AML; OR 2.33, 95% CI 1.25-4.37), retinoblastoma (OR 3.21, 95% CI 1.22-8.41) and germ cell tumors (OR 5.89, 95% CI 2.29-15.18) was increased among the preterm compared to term. Germ cell tumors were diagnosed at a significantly younger age among the preterm. Neonatal therapies, for example, mechanical ventilation, were associated with an increased risk of childhood cancer independent of gestational age. Preterm, especially early preterm birth, is associated with an increased risk of childhood cancer, especially germ cell tumors and AML. Respiratory distress requiring neonatal intervention also appears to be associated with an increased risk.
我们的目的是使用全国性的基于登记的病例对照设计研究早产和新生儿治疗对儿童癌症风险的影响。我们结合了芬兰医学出生登记处（MBR）和芬兰癌症登记处的基于人群的数据，确定了 1996 年至 2014 年间年龄在 20 岁以下的总共 2029 名癌症患者和 10103 名年龄和性别匹配的对照。MBR 提供了围产前和围产期的情况信息。孕龄分为早期（<32 周）、晚期早产（32-36 周）和足月（≥37 周）。使用条件逻辑回归评估与足月新生儿相比，早产儿的癌症风险。我们在早产儿中发现了 141 例癌症（678 例中的 20.8%），而在足月儿童中发现了 1888 例癌症（11454 例中的 16.5%）。早产的任何癌症风险均增加（优势比[OR] 1.28，95%置信区间[CI] 1.06-1.57），尤其是早期早产（OR 1.84，95% CI 1.16-2.92）。急性髓性白血病（AML；OR 2.33，95% CI 1.25-4.37）、视网膜母细胞瘤（OR 3.21，95% CI 1.22-8.41）和生殖细胞瘤（OR 5.89，95% CI 2.29-15.18）的风险在早产儿中均增加。与足月相比，早产儿的生殖细胞瘤诊断年龄明显较小。新生儿治疗，例如机械通气，与癌症风险增加有关，与孕龄无关。早产，尤其是早期早产，与儿童癌症风险增加有关，尤其是生殖细胞瘤和 AML。需要新生儿干预的呼吸窘迫似乎也与风险增加有关。
