Birth weight and childhood leukemia: A meta-analysis and review of the current evidence
Birth weight and childhood leukemia: A meta-analysis and review of the current evidence
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DOI：
10.1002/ijc.24225
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发表时间：
2009-06-01
影响因子：
6.4
通讯作者：
Michels, Karin B.
中科院分区：
文献类型：
--
作者：
Caughey, Robert W.;Michels, Karin B.
越来越多的证据表明，儿童白血病可能在子宫内开始，当时淋巴细胞和骨髓细胞尚未完全分化，特别容易发生恶性转化。一项固定效应荟萃分析研究了出生体重与儿童白血病之间的关系，包括32项研究，16,501例所有类型白血病（OL）， 10,974例急性淋巴细胞白血病（all）和1,832例急性髓性白血病（AML）。与正常出生体重相比，高出生体重与OL、ALL和AML相关的奇比（OR）分别为1.35 （95% CI: 1.24, 1.48）、1.23 （95% CI: 1.15, 1.32）和1.40 （95% CI: 1.11, 1.76）。低出生体重与总体和全部白血病无关，但与AML相关（OR = 1.50; 95% CI: 1.05, 2.13）。出生体重每增加1000克，OL的OR为1.18 (95% CI: 1.13,1.23)， ALL为1.18 （95% CI: 1.12,1.23）。观察性研究的综合现有证据表明，高出生体重与总体白血病和ALL风险增加有关。对于急性髓性白血病，出生体重的高和低两个极端都可能增加风险，提示u型关联。(C) 2008 Wiley-Liss, Inc。
A growing body of evidence suggests that childhood leukemia may be initiated in utero when lymphoid and myeloid cells are not fully differentiated and are particularly susceptible to malignant transformation. A fixed effects meta-analysis examining the association between birth weight and childhood leukemia was conducted including 32 studies and 16,501 cases of all types of leukemia (OL), 10,974 cases of acute lymphoblastic leukemia (ALL), and 1,832 cases of acute myeloid leukemia (AML). The odd ratios (OR) for the association of high birth weight with OL, ALL and AML were 1.35 (95% CI: 1.24, 1.48), 1.23 (95% CI: 1.15, 1.32), and 1.40 (95% CI: 1.11, 1.76), respectively, compared with normal birth weight. Low birth weight was not associated with overall and ALL leukemia, but with AML (OR = 1.50; 95% CI: 1.05, 2.13). Per 1000 g increase in birth weight, the OR for OL was 1.18 (95% CI: 1.13,1.23) and ALL 1.18 (95% CI: 1.12,1.23). The combined available evidence from observational studies suggests that high birth weight is associated with an increased risk of overall leukemia and ALL. For AML the risk may be elevated at both high and low extremes of birth weight, suggesting a U-shaped association. (C) 2008 Wiley-Liss, Inc.