Maternal health conditions during pregnancy and acute leukemia in children with Down syndrome: A Children's Oncology Group study.
Maternal health conditions during pregnancy and acute leukemia in children with Down syndrome: A Children's Oncology Group study.
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DOI：
10.1002/pbc.21914
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发表时间：
2009-05
影响因子：
3.2
通讯作者：
Ross JA
中科院分区：
文献类型：
--
作者：
Ognjanovic S;Puumala S;Spector LG;Smith FO;Robison LL;Olshan AF;Ross JA
患有唐氏综合症(DS)的儿童患白血病的风险增加约20倍。儿童早期感染可以预防患有和没有DS的儿童的急性淋巴细胞性白血病(ALL)。我们研究了母亲感染和孕期健康状况是否与DS儿童的急性白血病有关。我们对1997~2002年间158例DS和白血病(其中急性淋巴细胞白血病(ALL)97例，急性髓系白血病(AML)61例)和173例DS儿童进行了病例对照研究。产妇访谈包括关于怀孕期间可能引发炎症反应的14种产妇情况的信息。我们评估了它们在病例和对照中的患病率。其中五个足够常见，可以按白血病亚型进行分析。阴道出血是最常见的(18%的病例和25%的对照组)，并且与所有病例的风险降低(优势比(OR)=0.57；95%可信区间(CI)=0.33-0.99)相关。其他变量虽然显示出降低风险的潜在趋势，但其影响估计是不准确的，在统计上没有显著意义。相比之下，羊膜腔穿刺术与急性髓系白血病的风险增加略有关联(OR=2.06，95%CI=0.90-4.69)。这项探索性调查的数据表明，怀孕期间的一些健康状况可能与儿童白血病的发生有关。更大的流行病学研究和其他模型系统(动物、临床研究)可能会为潜在的关联和机制提供更清晰的图景。
Children with Down syndrome (DS) have about a 20-fold increased risk of developing leukemia. Early childhood infections may protect against acute lymphoid leukemia (ALL) in children with and without DS. We examined whether maternal infections and health conditions during pregnancy were associated with acute leukemia in children with DS. We conducted a case-control study of 158 children with DS and leukemia (including 97 cases with acute lymphoblastic leukemia (ALL) and 61 cases with acute myeloid leukemia (AML)) and 173 children with DS during the period 1997–2002. Maternal interview included information about fourteen maternal conditions during gestation that are likely to induce an inflammatory response. We evaluated their prevalence in cases and controls. Five of these were common enough to allow analyses by leukemia subtype. Vaginal bleeding was the most frequent (18% cases, 25% controls) and was associated with a reduced risk (Odds Ratio (OR)=0.57; 95% Confidence Interval (CI)=0.33–0.99) for all cases combined. Other variables, while showing a potential trend toward reduced risk had effect estimates which were imprecise and not statistically significant. In contrast, amniocentesis was marginally associated with an increased risk of AML (OR=2.06, 95%CI=0.90–4.69). Data from this exploratory investigation suggest that some health conditions during pregnancy may be relevant in childhood leukemogenesis. Larger epidemiologic studies and other model systems (animal, clinical studies) may provide a clearer picture of the potential association and mechanisms.
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影响因子：
168.9
作者：
Greaves, MF
通讯作者：
Greaves, MF
影响因子：
168.9
作者：
Hasle, H;Clemmensen, IH;Mikkelsen, M
通讯作者：
Mikkelsen, M
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9.8
作者：
Gomez, R;Romero, R;Gonzalez, R
通讯作者：
Gonzalez, R
影响因子：
3
作者：
CUCKLE, H;WALD, N;KNIGHT, G
通讯作者：
KNIGHT, G
影响因子：
3.6
作者：
LOCKITCH, G;SINGH, VK;QUIGLEY, G
通讯作者：
QUIGLEY, G