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评估母亲生育史、出生特征与婴儿白血病之间的关系:儿童癌症研究组的报告

Evaluating the relationships among maternal reproductive history, birth characteristics, and infant leukemia: a report from the Children's Cancer Group.

作者信息

Ross J A, Potter J D, Shu X O, Reaman G H, Lampkin B, Robison L L

机构信息

Division of Pediatric Epidemiology and Clinical Research, University of Minnesota, Minneapolis, USA.

出版信息

Ann Epidemiol. 1997 Apr;7(3):172-9. doi: 10.1016/s1047-2797(97)00012-4.

Abstract

PURPOSE

Specific events in the mother's reproductive history and certain birth characteristics have been associated with childhood leukemia. Few studies have explored these associations specifically in infants.

METHODS

The Children's Cancer Group (CCG) conducted three separate case-control studies of childhood leukemia that involved similar methodologies and data collection. Data from interviews of the mothers of a total of 303 children diagnosed with leukemia at 1 year of age or younger and their matched controls (n = 468) were available from the three studies. These data included maternal reproductive history (stillbirths, abortions, and miscarriages) and certain birth characteristics of the index child.

RESULTS

Compared with controls, cases were significantly more likely to be female (P < 0.01) and were more often heavier at birth (particularly cases diagnosed after 6 months of age (odds ratio, 4.18; 95% confidence interval, 1.75-10.02)). Overall, there were no statistically significant differences between cases and controls in regard to maternal report of any type of previous fetal loss. Finally, being a later-born child was associated with an increased risk of acute myeloid leukemia but not of acute lymphoblastic leukemia.

CONCLUSIONS

The relationships among birthweight, prior fetal loss, and risk of infant leukemia appear to be complex. Further studies of infant leukemia that incorporate molecular as well as epidemiologic data may help to elucidate these differences.

摘要

目的

母亲生殖史中的特定事件和某些出生特征与儿童白血病有关。很少有研究专门探讨这些关联在婴儿中的情况。

方法

儿童癌症研究组(CCG)开展了三项关于儿童白血病的独立病例对照研究,采用了相似的方法和数据收集方式。三项研究提供了对总共303名1岁及以下被诊断为白血病儿童的母亲及其匹配对照(n = 468)进行访谈的数据。这些数据包括母亲的生殖史(死产、流产和自然流产)以及索引儿童的某些出生特征。

结果

与对照组相比,病例组女性比例显著更高(P < 0.01),且出生时体重更重(尤其是6个月龄后诊断出的病例(比值比,4.18;95%置信区间,1.75 - 10.02))。总体而言,病例组和对照组在母亲报告的任何类型既往胎儿丢失方面无统计学显著差异。最后,后出生的孩子患急性髓系白血病的风险增加,但患急性淋巴细胞白血病的风险未增加。

结论

出生体重、既往胎儿丢失与婴儿白血病风险之间的关系似乎很复杂。纳入分子以及流行病学数据的婴儿白血病进一步研究可能有助于阐明这些差异。

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