Emeny Rebecca T, Ricci Angela M, Titus Linda, Morgan Alexandra, Bagley Pamela J, Blunt Heather B, Butow Mary E, Alford-Teaster Jennifer A, Iii Raymond R Walston, Rees Judy R
Department of Internal Medicine, Division of Molecular Medicine, UNM Comprehensive Cancer Center, Cancer Control & Population Sciences Research Program, University of New Mexico Health Sciences, Albuquerque, NM 87131, USA.
Department of Pediatrics, Division of Pediatric Hematology-Oncology, Dartmouth Health Children's, Lebanon, NH 03756, USA.
Cancers (Basel). 2025 Jul 29;17(15):2499. doi: 10.3390/cancers17152499.
To review parental pre-pregnancy and pregnancy exposures in relation to pediatric cancer (diagnosis before age 20).
We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 17 March 2021.
Strong evidence links increased risk of childhood cancer with maternal diabetes, age, and alcohol and coffee consumption during pregnancy. Both paternal and maternal cigarette smoking before and during pregnancy are associated with childhood cancers. Diethylstilbestrol (DES) exposure in utero has long been known to be causally associated with increased risk of vaginal/cervical cancers in adolescent girls. More recent evidence implicates in utero DES exposure to testicular cancer in young men and possible intergenerational effects on ovarian cancer in the granddaughters of women exposed to DES during pregnancy. There is strong evidence that childhood cancer risk is also associated with both high and very low birth weight and with gestational age. Evidence is also strong for the protective effects of maternal vitamin consumption and a healthy diet during pregnancy. Unlike early studies, those reviewed here show no association between in utero exposure to medical ionizing radiation, which may be explained by reductions over time in radiation doses, avoidance of radiation during pregnancy, and/or by inadequate statistical power to detect small increases in risk, rather than a lack of causal association. Evidence is mixed or conflicting for an association between childhood cancer and maternal obesity, birth order, cesarean/instrumental delivery, and prenatal exposure to diagnostic medical radiation. Evidence is weak or absent for associations between childhood cancer and multiple gestations or assisted reproductive therapies, as well as prenatal exposure to hormones other than DES, and medications.
回顾与儿童癌症（20岁前诊断）相关的父母孕前及孕期暴露情况。
我们使用Ovid Medline和Scopus进行文献检索，以查找2014年至2021年3月17日发表的原始研究、综述文章和荟萃分析。
有力证据表明，儿童癌症风险增加与母亲糖尿病、年龄以及孕期饮酒和咖啡摄入有关。父母在孕前和孕期吸烟均与儿童癌症有关。长期以来已知子宫内暴露于己烯雌酚（DES）与青春期女孩患阴道/宫颈癌风险增加存在因果关系。最近的证据表明，子宫内暴露于DES会增加年轻男性患睾丸癌的风险，并可能对孕期暴露于DES的女性的孙女患卵巢癌产生代际影响。有力证据表明，儿童癌症风险还与高出生体重和极低出生体重以及孕周有关。母亲孕期补充维生素和健康饮食具有保护作用的证据也很充分。与早期研究不同，此处综述的研究表明子宫内暴露于医用电离辐射之间无关联，这可能是由于辐射剂量随时间减少、孕期避免辐射和/或检测风险小幅增加的统计效力不足，而非缺乏因果关联。关于儿童癌症与母亲肥胖、出生顺序、剖宫产/器械助产以及产前暴露于诊断性医用辐射之间的关联，证据不一或相互矛盾。关于儿童癌症与多胎妊娠或辅助生殖治疗以及产前暴露于DES以外的激素和药物之间的关联，证据薄弱或不存在。
