Hemmingsen Caroline H, Kjaer Susanne K, Hjorth Sarah, Nörby Ulrika, Broe Anne, Pottegård Anton, Bénévent Justine, Schmiegelow Kjeld, Skovlund Charlotte Wessel, Leinonen Maarit K, Nordeng Hedvig, Mørch Lina S, Hargreave Marie
Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark; Department of Gynaecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Eur J Cancer. 2025 Jan 17;215:115168. doi: 10.1016/j.ejca.2024.115168. Epub 2024 Dec 7.
Maternal hormonal contraception use has been associated with childhood leukemia risk. However, studies are few and often based on self-reported information.
Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996-2018) and followed them from birth until leukemia diagnosis, censoring (death, emigration, other cancer, 20th birthday) or study closure (December 31st, 2017, 2018 or 2020). We estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for childhood leukemia (any, lymphoid and non-lymphoid) associated with maternal recent use (≤ 3 months before or during pregnancy) or previous use (before recent use) of hormonal contraception overall and by type, compared to no use.
During 29,455,528 person-years, 1701 children developed leukemia (no use: 518, previous use: 974, recent use: 209). Maternal recent use of hormonal contraception was associated with an increased leukemia risk in children (HR 1.22, 95 % CI 1.04-1.44; incidence rate per 1,000,000 person-years [IR] 65), compared to no use (IR 53). The association was strongest for non-lymphoid leukemia (HR 1.69, 95 % CI 1.20-2.37) and mainly driven by the oral combined products, both for any leukemia (HR 1.29, 95 % CI 1.05-1.59) and non-lymphoid leukemia (HR 1.75, 95 % CI 1.17-2.62). Additionally, non-lymphoid leukemia was associated with recent use of the non-oral progestin-only products (HR 2.10, 95 % CI 1.28-3.44).
Although the absolute risk was low, maternal hormonal contraception use up to or during pregnancy was associated with an increased childhood leukemia risk, particularly non-lymphoid leukemia, and mainly driven by oral combined and non-oral progestin-only products.
母亲使用激素避孕与儿童白血病风险相关。然而，相关研究较少，且往往基于自我报告信息。
利用丹麦、挪威和瑞典的登记数据，我们确定了3183316名儿童（出生于1996 - 2018年），并对他们从出生开始进行随访，直至白血病诊断、审查（死亡、移民、其他癌症、20岁生日）或研究结束（2017年、2018年或2020年12月31日）。我们估计了与母亲近期使用（怀孕前或怀孕期间≤3个月）或以前使用（近期使用之前）激素避孕总体及按类型相比，未使用激素避孕时儿童白血病（任何类型、淋巴细胞性和非淋巴细胞性）的风险比（HRs）和95%置信区间（CIs）。
在29455528人年期间，1701名儿童患白血病（未使用：518例，以前使用：974例，近期使用：209例）。与未使用激素避孕相比（发病率每100万人年[IR]53），母亲近期使用激素避孕与儿童白血病风险增加相关（HR 1.22，95%CI 1.04 - 1.44；IR 65）。这种关联在非淋巴细胞性白血病中最强（HR 1.69，95%CI 1.20 - 2.37），并且主要由口服复方制剂驱动，对于任何白血病（HR 1.29，95%CI 1.05 - 1.59）和非淋巴细胞性白血病（HR 1.75，95%CI 1.17 - 2.62）均如此。此外，非淋巴细胞性白血病与近期使用非口服单纯孕激素产品相关（HR 2.10，95%CI 1.28 - 3.44）。
尽管绝对风险较低，但母亲在怀孕前或怀孕期间使用激素避孕与儿童白血病风险增加相关，尤其是非淋巴细胞性白血病，并且主要由口服复方制剂和非口服单纯孕激素产品驱动。
