Maternal prenatal cigarette, alcohol and illicit drug use and risk of infant leukaemia: a report from the Children's Oncology Group.
Maternal prenatal cigarette, alcohol and illicit drug use and risk of infant leukaemia: a report from the Children's Oncology Group.
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DOI：
10.1111/j.1365-3016.2011.01229.x
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发表时间：
2011-11
影响因子：
2.8
通讯作者：
Ross JA
中科院分区：
文献类型：
--
作者：
Slater ME;Linabery AM;Blair CK;Spector LG;Heerema NA;Robison LL;Ross JA
一些病例对照研究评价了母亲在怀孕期间吸烟、饮酒和使用非法药物与儿童白血病风险之间的关系。很少有研究专门关注患有白血病的婴儿（<1岁），这是一个在生物学和临床上与年龄较大的儿童不同的群体。我们目前的数据来自儿童肿瘤组病例对照研究，研究对象为1996年至2006年期间诊断为急性白血病（包括急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML））的443名婴儿和324名对照人群。母亲们在怀孕前1年和整个怀孕期间被询问了他们的香烟，酒精和非法药物使用情况。采用校正的非条件logistic回归模型计算比值比（OR）和95%置信区间（CI）。母亲在怀孕前和/或怀孕期间吸烟（>1支/天）和使用非法药物（任何数量）与婴儿白血病没有显著相关性。妊娠期饮酒（>1杯/周）与婴儿总体白血病[OR = 0.64; 95% CI 0.43，0.94]、AML [OR = 0.49; 95% CI 0.28，0.87]和混合谱系白血病基因重排（“MLL+”）[OR = 0.59; 95% CI 0.36，0.97]呈负相关。虽然我们的研究结果与母亲吸烟与儿童白血病无关的相当一致的证据相一致，但有关酒精和非法药物使用的数据与先前的报告不一致，并且难以解释。怀孕期间不健康的母亲行为，其中一些可能会带来潜在的法律的后果，可能无法仅通过自我报告进行充分衡量。未来的儿童白血病病例对照研究，追求这些风险可能会受益于纳入验证仪器和/或生物标志物时，可行的。
Several case–control studies have evaluated associations between maternal smoking, alcohol consumption and illicit drug use during pregnancy and risk of childhood leukaemia. Few studies have specifically focused on infants (<1 year) with leukaemia, a group that is biologically and clinically distinct from older children. We present data from a Children’s Oncology Group case–control study of 443 infants diagnosed with acute leukaemia [including acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML)] between 1996 and 2006 and 324 population controls. Mothers were queried about their cigarette, alcohol and illicit drug use 1 year before and throughout pregnancy. Odds ratios (ORs) and 95% confidence intervals [CI] were calculated using adjusted unconditional logistic regression models. Maternal smoking (>1 cigarette/day) and illicit drug use (any amount) before and/or during pregnancy were not significantly associated with infant leukaemia. Alcohol use (>1 drink/week) during pregnancy was inversely associated with infant leukaemia overall [OR = 0.64; 95% CI 0.43, 0.94], AML [OR = 0.49; 95% CI 0.28, 0.87], and leukaemia with mixed lineage leukaemia gene rearrangements (‘MLL+’) [OR = 0.59; 95% CI 0.36, 0.97]. While our results agree with the fairly consistent evidence that maternal cigarette smoking is not associated with childhood leukaemia, the data regarding alcohol and illicit drug use are not consistent with prior reports and are difficult to interpret. It is possible that unhealthy maternal behaviours during pregnancy, some of which carry potential legal consequences, may not be adequately measured using only self-report. Future case–control studies of childhood leukaemia that pursue these exposures may benefit from incorporation of validated instruments and/or biomarkers when feasible.
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