Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA.
Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA.
Eur J Epidemiol. 2024 Sep;39(9):1005-1011. doi: 10.1007/s10654-024-01149-x. Epub 2024 Sep 18.
Results from studies investigating the association between maternal or child epilepsy, use of anticonvulsants in pregnancy, and childhood cancer are inconsistent and at times contradictory. Linking Danish national databases, we obtained epilepsy and childhood cancer diagnoses, and anticonvulsant use data. We estimated adjusted odds ratios of all or specific childhood cancers in relation to maternal or child epilepsy and anticonvulsant therapies using conditional logistic regression. Maternal epilepsy was positively associated with all childhood cancers in offspring, specifically, with acute lymphoblastic leukemia (Odds Ratio (OR) = 1.68, 95% Confidence Interval (CI) = 1.16, 2.43) and Wilms tumor (OR = 2.13, 95% CI = 0.97, 4.68). When considering maternal ever (lifetime) ingestion of anticonvulsants, a positive association was found with all cancers (OR = 1.14, 95% CI = 1.00, 1.30), and central nervous system tumors (CNS) (OR = 1.36, 95% CI = 1.04, 1.76) as well as neuroblastoma (OR = 1.76, 95% CI = 1.06, 2.90) among offspring. Maternal anticonvulsant use before or during the index pregnancy was related to CNS tumors in offspring (OR = 1.99, 95% CI = 0.99, 4.00).
研究表明，母体或儿童癫痫、妊娠期间使用抗癫痫药物与儿童癌症之间的关联结果并不一致，甚至有时相互矛盾。通过链接丹麦国家数据库，我们获得了癫痫和儿童癌症诊断以及抗癫痫药物使用的数据。我们使用条件逻辑回归估计了母体或儿童癫痫和抗癫痫治疗与所有或特定儿童癌症之间的调整比值比。母体癫痫与所有儿童癌症，特别是急性淋巴细胞白血病（优势比（OR）= 1.68，95%置信区间（CI）= 1.16，2.43）和威尔姆斯瘤（OR = 2.13，95%CI = 0.97，4.68）呈正相关。当考虑母体曾（终生）服用抗癫痫药物时，发现与所有癌症（OR = 1.14，95%CI = 1.00，1.30）以及中枢神经系统肿瘤（CNS）（OR = 1.36，95%CI = 1.04，1.76）和神经母细胞瘤（OR = 1.76，95%CI = 1.06，2.90）呈正相关。母体在指数妊娠前或妊娠期间使用抗癫痫药物与后代的中枢神经系统肿瘤有关（OR = 1.99，95%CI = 0.99，4.00）。
