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Effects of hypertension and use of antihypertensive drugs in pregnancy on the risks of childhood cancers in Taiwan

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Abstract

Background

Childhood cancers are associated with high mortality and morbidity, and some maternal prescription drug use during pregnancy has been implicated in cancer risk. There are few studies on the effects of hypertension, preeclampsia, and the use of antihypertensives in pregnancy on children’s cancer risks.

Objective

This population-based cohort study analyzed the relationship between hypertension, preeclampsia, and antihypertensives taken during pregnancy and the risks of childhood cancers in the offspring.

Methods

Data on all children born in Taiwan between 2004 and 2015 (N = 2,294,292) were obtained from the Maternal and Child Health Database. This registry was linked with the National Health Insurance Database and Cancer Registry to get the records of maternal use of diuretics or other antihypertensives in pregnancy and records of children with cancer diagnosed before 13 years. We used Cox proportional hazard modeling to estimate the influence of maternal health conditions and antihypertensive drug exposure on the risks of developing childhood cancers.

Results

Offspring of mothers with hypertension (chronic or gestational) had a higher risk of acute lymphocytic lymphoma [hazard ratio (HR) = 1.87, 95% Confidence Interval (CI) 1.32 – 2.65] and non-Hodgkin’s lymphoma (HR = 1.96, 95% CI 1.34 – 2.86). We estimated only a weak increased cancer risk in children whose mothers used diuretics (HR = 1.16, 95% CI 0.77 – 1.74) or used antihypertensives other than diuretics (HR = 1.15, 95% CI 0.86 – 1.54) before birth.

Conclusions

In this cohort study, children whose mothers had chronic and gestational hypertension had an increased risk of developing childhood cancer.

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Data availability

This study is based on deidentified information from Taiwan national health insurance and registries, and permission is required prior to data access. Further details are available from the corresponding author upon request.

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Funding

This work was supported by the US National Institutes of Health (grant number R03CA273608) and Alex’s Lemonade Stand Foundation (grant number 17-01882), and PCL is supported in part by the National Science and Technology Council (NSTC 112-2314-B-006-068-MY3).

Author information

Authors and Affiliations

  1. College of Health and Public Service, University of North Texas, Denton, TX, USA

    Helen T. Orimoloye & Julia E. Heck

  2. Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan

    Ya-Hui Hu, Chung-Yi Li & Pei-Chen Lee

  3. Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA

    Noah Federman

  4. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Beate Ritz, Onyebuchi A. Arah & Julia E. Heck

  5. Department of Statistics and Data Science, College of Letters and Science, University of California, Los Angeles, CA, USA

    Onyebuchi A. Arah

  6. Research Unit for Epidemiology, Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark

    Onyebuchi A. Arah

  7. Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan

    Chung-Yi Li

  8. Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan

    Chung-Yi Li

Authors
  1. Helen T. Orimoloye
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  2. Ya-Hui Hu
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  3. Noah Federman
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  4. Beate Ritz
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  6. Chung-Yi Li
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  7. Pei-Chen Lee
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  8. Julia E. Heck
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Contributions

H.T. wrote the main manuscript text. YH.H performed all the analyses, and took responsibility for the accuracy of the data analysis. N.F, B.R, O.A.,and CY.L. took responsibility for results interpretation and critically revised the manuscript for important intellectual content. PC.L. and J.H. designed the study, and took responsibility for the analysis plan, results interpretation, and critically revised the manuscript for important intellectual content. All authors reviewed the manuscript.

Corresponding author

Correspondence to Pei-Chen Lee.

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Orimoloye, H.T., Hu, YH., Federman, N. et al. Effects of hypertension and use of antihypertensive drugs in pregnancy on the risks of childhood cancers in Taiwan. Cancer Causes Control (2024). https://doi.org/10.1007/s10552-024-01864-6

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