Maternal comorbidities, prescription drug use in pregnancy and childhood cancer

描述(申请人提供)：近年来，越来越多的人认识到产妇健康和子宫环境对儿童日后健康的重要性。许多妇女在怀孕期间经历慢性或急性健康状况，少数研究将某些状况与儿童癌症风险增加联系起来。产妇保健还可能涉及使用药物来治疗先前存在的疾病或在产前期间发展起来的疾病。众所周知，母亲摄入己烯雌酚(DES)会导致后代癌症，但对于大多数药物来说，关于怀孕安全性的证据有限。这项研究的目的是检查常见的孕产妇健康状况和怀孕期间处方药的使用与儿童晚期癌症发展的关系。具体目标：(1)建立丹麦所有儿童癌症的链接数据库(1977-2012年)，提供有关产妇合并症和用药情况的信息。(2)探讨母体合并症与儿童癌症的关系。(3)探讨母亲孕期处方药使用与儿童癌症的关系。设计和方法：一项使用丹麦国家登记处的全国病例对照研究，使用来自丹麦儿童癌症现有研究的数据(n=537,000)。将从丹麦国家病人登记册(1977-2012年)获得产妇共病信息，从丹麦国家处方登记册(1994-2012年)获得孕期处方药使用情况。有关人口、妊娠和其他因素的数据将从其他国家登记中获得。影响：这些发现将增加母亲有特定健康状况或在怀孕期间服用特定药物的儿童患癌症风险的证据。结果将表明是否需要更积极的监测和筛查，以降低胎儿潜在增加的风险，并有助于指导怀孕期间使用药物的建议。

DESCRIPTION (provided by applicant): In recent years there has been a growing recognition of the importance of maternal health and the uterine environment in the later health of children. Many women experience chronic or acute health conditions while pregnant, and a few studies have linked certain conditions with increased pediatric cancer risk. Maternal health care may further involve the use of medications to treat a preexisting condition or a condition that develops during the prenatal period. It is well-established that maternal intake of diethylstilbestrol (DES) causes cancer in offspring, however for most drugs, the evidence on safety in pregnancy is limited. The aim of this study is to examine common maternal health conditions and prescription drug use in pregnancy in relation to later childhood cancer development. Specific aims: (1) Create a linked database of all childhood cancers in Denmark (1977-2012) with information on maternal comorbidities and medication use. (2) Examine the relation between maternal comorbid conditions and childhood cancers. (3) Examine the relation between maternal prescription drug use in pregnancy and childhood cancers. Design and methods: A national case-control study using national registries in Denmark, using data from an existing study on childhood cancers in Denmark (n=537,000). Maternal comorbidity information will be available from the Danish National Patient Register (1977-2012), and prescription drug use in pregnancy from the Danish National Prescription Register (1994-2012). Data on demographic, gestational, and other factors will be available from other national registers. Implications: the findings will add evidence on childhood cancer risk among children of mothers with certain health conditions or who took specific medications during pregnancy. The results will indicate if more active monitoring and screening is needed to reduce the potentially increased risk for the unborn child, and can help guide recommendations on medication use in pregnancy.