Maternal Body Mass Index, Diabetes, and Gestational Weight Gain and Risk for Pediatric Cancer in Offspring: A Systematic Review and Meta-Analysis.
Maternal Body Mass Index, Diabetes, and Gestational Weight Gain and Risk for Pediatric Cancer in Offspring: A Systematic Review and Meta-Analysis.
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DOI：
10.1093/jncics/pkac020
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发表时间：
2022-03-02
影响因子：
4.4
通讯作者：
Spector LG
中科院分区：
文献类型：
--
作者：
Marley AR;Domingues A;Ghosh T;Turcotte LM;Spector LG
在成人肥胖增加的同时，儿童癌症发病率稳步上升，但母体肥胖和相关的合并症与儿童癌症风险之间的关系仍未得到充分研究。我们的目标是定量描述儿科癌症风险与孕前体重指数(BMI)、孕期体重增加和母体糖尿病之间的关系。我们对Ovid和EMBASE从成立到2021年3月15日的文献进行了全面、系统的检索。符合条件的研究报告了风险估计和样本量，并提供了对结果和暴露确定的充分说明。随机效应模型用于估计集合效应。这项分析包括34项研究。孕前BMI与子代患白血病的风险呈正相关(OR=1.07，95%可信区间[CI]=1.04~1.11；I2=0.0%)。任何母亲糖尿病与急性淋巴细胞白血病的风险正相关(OR=1.46，95%CI=1.28~1.67；I2=0.0%)，即使在限制出生体重调整的分析后(OR=1.74，95%CI=1.29~2.34；I2=0.0%)，与中枢神经系统肿瘤的风险负相关(OR=0.73，95%CI=0.55~0.97；I2=0.0%)。妊娠期糖尿病(OR=1.57，95%CI=1.11~2.24；I2=26.8%)和妊娠期糖尿病(OR=1.40，95%CI=1.12~1.75；I2=0.0%)与急性淋巴细胞白血病的危险性呈正相关。没有观察到与妊娠体重增加有统计学意义的相关性。母亲肥胖和糖尿病可能在病因上与儿童癌症有关，特别是白血病和中枢神经系统肿瘤。我们的发现支持体重管理和血糖控制作为母子健康的重要组成部分。进一步验证是有必要的。
Pediatric cancer incidence has steadily increased concurrent with rising adult obesity, but associations between maternal obesity and associated comorbidities and pediatric cancer risk remain understudied. We aimed to quantitatively characterize associations of pediatric cancer risk with maternal prepregnancy body mass index (BMI), gestational weight gain, and maternal diabetes. We performed a comprehensive and systematic literature search in Ovid and EMBASE from their inception to March 15, 2021. Eligible studies reported risk estimates and sample sizes and provided sufficient description of outcome and exposure ascertainment. Random effects models were used to estimate pooled effects. Thirty-four studies were included in the analysis. Prepregnancy BMI was positively associated with leukemia risk in offspring (odds ratio [OR] per 5-unit BMI increase =1.07, 95% confidence intervals [CI] = 1.04 to 1.11; I2 = 0.0%). Any maternal diabetes was positively associated with acute lymphoblastic leukemia risk (OR = 1.46, 95% CI = 1.28 to 1.67; I2 = 0.0%), even after restricting to birthweight-adjusted analyses (OR = 1.74, 95% CI = 1.29 to 2.34; I2 = 0.0%), and inversely associated with risk of central nervous system tumors (OR = 0.73, 95% CI = 0.55 to 0.97; I2 = 0.0%). Pregestational diabetes (OR = 1.57, 95% CI = 1.11 to 2.24; I2 = 26.8%) and gestational diabetes (OR = 1.40, 95% CI = 1.12 to 1.75; I2 = 0.0%) were also positively associated with acute lymphoblastic leukemia risk. No statistically significant associations were observed for gestational weight gain. Maternal obesity and diabetes may be etiologically linked to pediatric cancer, particularly leukemia and central nervous system tumors. Our findings support weight management and glycemic control as important components of maternal and offspring health. Further validation is warranted.
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影响因子：
6.4
作者：
Caughey, Robert W.;Michels, Karin B.
通讯作者：
Michels, Karin B.
影响因子：
4
作者：
Ghosh T;Richardson M;Gordon PM;Ryder JR;Spector LG;Turcotte LM
通讯作者：
Turcotte LM
影响因子：
3.2
作者：
Ognjanovic S;Puumala S;Spector LG;Smith FO;Robison LL;Olshan AF;Ross JA
通讯作者：
Ross JA
影响因子：
6.2
作者：
Chow, Eric J.;Friedman, Debra L.;Mueller, Beth A.
通讯作者：
Mueller, Beth A.
影响因子：
6.4
作者：
Bailey, Helen D.;Rios, Paula;Clavel, Jacqueline
通讯作者：
Clavel, Jacqueline