Preston-Martin S, Pogoda J M, Mueller B A, Lubin F, Holly E A, Filippini G, Cordier S, Peris-Bonet R, Choi W, Little J, Arslan A
Department of Preventive Medicine, University of Southern California, USC/Norris Cancer Center, Los Angeles, USA.
Int J Cancer Suppl. 1998;11:17-22.
An international case-control study of primary pediatric brain tumors included interviews with mothers of cases diagnosed from 1976 to 1994 and mothers of population controls. Data are available on maternal vitamin use during pregnancy for 1,051 cases and for 1,919 controls from 8 geographic areas in North America, Europe and Israel. While risk estimates varied by study center, combined results suggest that maternal supplementation for 2 trimesters decreased risk of brain tumor [odds ratio (OR) = 0.7; 95% confidence interval (CI) = 0.5, 0.9], with a trend of less risk with longer duration of use (p trend = 0.0007). The greatest risk reduction was among children diagnosed under 5 years of age whose mothers used supplements during all 3 trimesters (OR = 0.5; CI = 0.3, 0.8). This effect did not vary by histology and was seen for supplementation during pregnancy rather than during the month before pregnancy or while breastfeeding. Our findings are largely driven by data from the United States, where most mothers took vitamins. The proportion of control mothers who took vitamins during pregnancy varied markedly from 3% in Israel and in France, 21% in Italy, 33% in Canada and 52% in Spain to 86-92% at the 3 U.S. centers. The composition of the various multivitamin compounds taken also varied: daily dose of vitamin C ranged from 0 to 600 mg; vitamin E from 0 to 70 mg; vitamin A from 0 to 30,000 IU; and folate from 0 to 2,000 micrograms. Mothers also took individual micronutrient supplements (e.g., vitamin C tablets), but most mothers who took these also took multivitamins, making it impossible to determine the potential independent effects of these micronutrients.
一项关于儿童原发性脑肿瘤的国际病例对照研究，对1976年至1994年期间确诊病例的母亲以及人群对照的母亲进行了访谈。现有来自北美、欧洲和以色列8个地理区域的1051例病例和1919例对照的孕期母亲维生素使用数据。虽然风险估计因研究中心而异，但综合结果表明，母亲孕期补充维生素2个孕期可降低脑肿瘤风险[比值比（OR）=0.7；95%置信区间（CI）=0.5，0.9]，且使用时间越长风险越低的趋势（p趋势=0.0007）。风险降低最大的是5岁以下儿童，其母亲在整个3个孕期都使用补充剂（OR=0.5；CI=0.3，0.8）。这种效应不因组织学而异，且在孕期补充而非孕前一个月或哺乳期补充时可见。我们的研究结果主要由美国的数据驱动，在美国大多数母亲服用维生素。孕期服用维生素的对照母亲比例差异显著，从以色列和法国的3%、意大利的21%、加拿大的33%、西班牙的52%到美国3个中心的86 - 92%。所服用的各种复合维生素化合物的成分也有所不同：维生素C的每日剂量从0到600毫克；维生素E从0到70毫克；维生素A从0到30000国际单位；叶酸从0到2000微克。母亲们也服用单一微量营养素补充剂（如维生素C片），但大多数服用这些补充剂的母亲也服用复合维生素，因此无法确定这些微量营养素的潜在独立作用。
