Cnattingius S, Zack M, Ekbom A, Gunnarskog J, Linet M, Adami H O
Department of Obstetrics and Gynaecology, University Hospital, Uppsala University, Sweden.
Cancer Epidemiol Biomarkers Prev. 1995 Jul-Aug;4(5):441-5.
Information about the etiology of childhood myeloid leukemia is limited. A population-based nested case-control study of prenatal and neonatal risk factors for childhood myeloid leukemia was performed with the use of the Swedish National Cancer Register and the Swedish Birth Register. A total of 98 cases of myeloid leukemia were identified in successive birth cohorts from 1973 through 1989. From the Birth Register, five controls were matched to each case. Fourteen of the 98 cases with myeloid leukemia and none of the controls had Down syndrome [odds ratio (OR) = infinity; 95% confidence interval (CI) = 21.0-infinity]. The risk for myeloid leukemia also increased among children who had physiological jaundice (OR = 2.5; 95% CI = 1.2-5.0; children who had been treated with phototherapy (OR = 7.5; 95% CI = 1.8-31.9); or who had been treated in an incubator (OR = 3.5; 95% CI = 1.2-10.2). Excluding cases with Down syndrome, however, decreased these risks, so that their 95% lower confidence interval included the no-effect value. Maternal age < 20 years old (OR = 2.5; 95% CI = 1.1-6.0), hypertension (OR = 2.4; 95% CI = 1.2-5.0), Cesarean section (OR = 2.5; 95% CI = 1.3-4.9), maternal smoking (OR = 2.4; 95% CI = 0.9-6.5), and being one of a multiple birth (OR = 3.6; 95% CI = 1.1-11.3) increased the risk for myeloid leukemia among those without Down syndrome. When the analyses were repeated, by restricting the cases to those with acute myeloid leukemia, the risk associated with young maternal age declined and became nonsignificant.(ABSTRACT TRUNCATED AT 250 WORDS)
儿童髓系白血病的病因信息有限。利用瑞典国家癌症登记册和瑞典出生登记册，开展了一项基于人群的巢式病例对照研究，以探讨儿童髓系白血病的产前和新生儿期危险因素。在1973年至1989年连续出生队列中，共确定了98例髓系白血病病例。从出生登记册中，为每个病例匹配5名对照。98例髓系白血病病例中有14例患有唐氏综合征，而对照中无人患唐氏综合征[比值比（OR）=无穷大；95%置信区间（CI）=21.0 - 无穷大]。生理性黄疸患儿（OR = 2.5；95% CI = 1.2 - 5.0）、接受过光疗的患儿（OR = 7.5；95% CI = 1.8 - 31.9）或在暖箱中治疗过的患儿（OR = 3.5；95% CI = 1.2 - 10.2）患髓系白血病的风险也增加。然而，排除唐氏综合征病例后，这些风险降低，因此其95%置信区间下限包含无效应值。母亲年龄<20岁（OR = 2.5；95% CI = 1.1 - 6.0）、高血压（OR = 2.4；95% CI = 1.2 - 5.0）、剖宫产（OR = 2.5；95% CI = 1.3 - 4.9）、母亲吸烟（OR = 2.4；95% CI = 0.9 - 6.5）以及多胞胎之一（OR = 3.6；95% CI = 1.1 - 11.3）会增加非唐氏综合征患儿患髓系白血病的风险。重复进行分析，将病例限制为急性髓系白血病患者时，与年轻母亲年龄相关的风险降低且无统计学意义。（摘要截选至250词）
