Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Finnish Cancer Registry, Helsinki, Finland.
Acta Paediatr. 2021 Jul;110(7):2259-2266. doi: 10.1111/apa.15821. Epub 2021 Mar 8.
Autoimmune disease and its medication are associated with increased cancer risk in adults, but it is unknown whether maternal autoimmune disease and/or medication use in pregnancy are associated with increased cancer risk in offspring.
In this case-control study, we identified all patients under 20 years of age with their first cancer diagnosis in 1996-2014 from the Finnish Cancer Registry (n = 2029) and 1:5 population-based controls (n = 10,103) from the Medical Birth Register. We obtained information on maternal autoimmune disease and its medication from the relevant Finnish registries and used conditional logistic regression to analyse the risk of offspring cancer after maternal autoimmune disease exposure.
The odds ratio (OR) for cancer in offspring following maternal autoimmune exposure was 0.76 (95% confidence interval [CI] 0.47-1.23). Individual ORs for inflammatory bowel and connective tissue diseases were 1.08 (95% CI 0.56-2.01) and 0.50 (95% CI 0.23-1.08), respectively. The OR for maternal autoimmune medication was 0.95 (95% CI 0.80-1.14) overall and similar by drug subtype. There was an increased risk with medication in late pregnancy but the ORs were unstable owing to small numbers.
Our study does not support an increased cancer risk among offspring of women with autoimmune disease or its medication during pregnancy.
自身免疫性疾病及其药物治疗与成年人的癌症风险增加相关,但尚不清楚母体自身免疫性疾病和/或孕期用药是否与后代的癌症风险增加相关。
在这项病例对照研究中,我们从芬兰癌症登记处(n=2029)确定了 1996 年至 2014 年间所有 20 岁以下首次诊断出癌症的患者,并从医疗出生登记处获得了 1:5 基于人群的对照(n=10103)。我们从相关的芬兰登记处获得了关于母体自身免疫性疾病及其药物治疗的信息,并使用条件逻辑回归分析了母体自身免疫性疾病暴露后后代癌症的风险。
母体自身免疫性暴露后子女患癌症的比值比(OR)为 0.76(95%置信区间[CI]0.47-1.23)。炎症性肠病和结缔组织疾病的个体 OR 分别为 1.08(95% CI 0.56-2.01)和 0.50(95% CI 0.23-1.08)。母体自身免疫性药物治疗的总体 OR 为 0.95(95% CI 0.80-1.14),且按药物亚型分类相似。在妊娠晚期用药的风险增加,但由于数量较少,OR 不稳定。
我们的研究不支持母体自身免疫性疾病或孕期用药与后代癌症风险增加相关。