Hemmingsen Caroline H, Kjaer Susanne K, Hjorth Sarah, Nörby Ulrika, Pottegård Anton, Mathiasen René, Skovlund Charlotte Wessel, Leinonen Maarit K, Nordeng Hedvig, Mørch Lina S, Hargreave Marie
Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
Department of Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Int J Cancer. 2025 Oct 15;157(8):1557-1565. doi: 10.1002/ijc.35509. Epub 2025 Jun 5.
An association between maternal hormonal contraception use and childhood central nervous system (CNS) tumors has been suggested, but findings are inconclusive. This population-based cohort study includes Scandinavian nationwide registry data on liveborn children (1996-2018). Children were followed from birth until CNS tumor (<20 years) or censoring (other cancer, emigration, death, 20th birthday, or end of follow-up in 2017-2020). Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between maternal hormonal contraception use (any type, type-specific) and CNS tumor risk (any, any malignant, type-specific). Maternal use was categorized as "recent use" (0-3 months before or during pregnancy, except for non-oral progestin-only types), "previous use" (before recent use), and "no use". A total of 3,183,316 children were followed for 29,455,528 person-years, during which time 1384 children developed a CNS tumor (610 malignant). Compared with no use, maternal previous or recent use of any hormonal contraception (HR 0.93, 95% CI 0.82-1.05; HR 0.99, 95% CI 0.83-1.19), combined and progestin-only types (oral, non-oral), were not associated with childhood CNS tumor risk. However, maternal recent progestin-only injection use was associated with malignant childhood CNS tumors (HR 3.95, 95CI % 1.46-10.68), compared with no use (number needed to harm: 1 per 14,577 person-years). In conclusion, no association was found between maternal use of common types of hormonal contraception and CNS tumors in children. The rarely used progestin-only injections (medroxyprogesterone acetate) were associated with malignant CNS tumor risk in children, though based on few children.
有人提出母亲使用激素避孕与儿童中枢神经系统（CNS）肿瘤之间存在关联，但研究结果尚无定论。这项基于人群的队列研究纳入了斯堪的纳维亚半岛全国范围内关于活产儿童（1996 - 2018年）的登记数据。对儿童从出生开始进行随访，直至发生中枢神经系统肿瘤（<20岁）或被截尾（患其他癌症、移民、死亡、年满20岁或在2017 - 2020年随访结束）。Cox比例风险模型估计了母亲使用激素避孕（任何类型、特定类型）与中枢神经系统肿瘤风险（任何、任何恶性、特定类型）之间关联的风险比（HRs）和95%置信区间（95% CIs）。母亲的使用情况分为“近期使用”（怀孕前或怀孕期间0 - 3个月，但不包括仅含非口服孕激素的类型）、“既往使用”（在近期使用之前）和“未使用”。总共对3183316名儿童进行了29455528人年的随访，在此期间有1384名儿童患上了中枢神经系统肿瘤（610例为恶性）。与未使用相比，母亲既往或近期使用任何激素避孕方法（HR 0.93，95% CI 0.82 - 1.05；HR 0.99，95% CI 0.83 - 1.19），包括复方和仅含孕激素的类型（口服、非口服），均与儿童中枢神经系统肿瘤风险无关。然而，与未使用相比，母亲近期仅使用孕激素注射与儿童恶性中枢神经系统肿瘤有关（HR 3.95，95% CI 1.46 - 10.68）（危害所需人数：每14577人年1例）。总之，未发现母亲使用常见类型的激素避孕与儿童中枢神经系统肿瘤之间存在关联。极少使用的仅含孕激素注射剂（醋酸甲羟孕酮）与儿童恶性中枢神经系统肿瘤风险有关，不过基于的儿童数量较少。
