Birthweight by gestational age and childhood cancer
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The objective of this research was to compare the association of birthweight alone with gender-specific birthweight-for-gestational age on childhood cancer risk in a large population-based case–control study in Germany. Incident cases of childhood cancer (n = 2,024, diagnosed 1992–1994) were ascertained from the German Childhood Cancer Registry. Controls were randomly drawn from population registries. Parents reported risk factor information in a mailed questionnaire and telephone interview. The odds ratio for acute lymphoblastic leukemia (ALL) was 1.41 (95% confidence interval 1.08–1.84) in the high-birthweight category (>4 kg) and was 1.45 (1.07–1.97) in the large-for-gestational age (LGA) category compared to the normal birthweight (2.5–4 kg) and the appropriate-for-gestational age (AGA) categories, respectively. However, the agreement between the birthweight and birthweight-for-gestational age was only moderate. Subgroup analyses revealed elevated odds ratios for ALL and CNS tumors in first born’s who were LGA but of normal birth weight. Thus, two findings from this post-hoc analysis are worthy of note: (1) the use of birthweight-for-gestation age categories within birthweight sub-groups potentially identified new high-risk groups among firstborns for ALL tumors and among all children for CNS tumors; and (2) although the magnitudes of risk estimators for ALL were comparable in the traditional high-birthweight group and in the LGA, the same children were not jointly classified in the same newborn categories indicating two potentially different subsets of children at risk.
KeywordsBirthweight Cancer etiology Childhood cancer Childhood leukemia Gestational age
Acute lymphoblastic leukemia
Acute myeloblastic leukemia
Central nervous system
The authors like to thank Dr Susanne Queißer-Luft (University of Mainz) and Klaus Schlaefer (German Cancer Research Center) for providing data from the Mainzer birth registry. Furthermore, the authors like to thank Drs Peter Kaatsch and Jörg Michaelis for the provision of the data of the German case–control study to perform these additional analyses.
- 1.Little J (1990) Epidemiology of childhood cancer. IARC Scientific Publications No149. Lyon, FranceGoogle Scholar
- 8.Godfrey KM (2001) The ‘Gold Standard’ for optimal fetal growth and development. J Pedatri Endocrinol Metab 14:1507–1514Google Scholar
- 16.Stokes ME, Davis CS, Koch GG (1995) Categorical data analysis using the SAS System. SAS Institute Inc., Cary, NC, USAGoogle Scholar
- 22.Lof M, Olausson H, Bostrom K, Janerot-Sjoberg B, Sohlstrom A, Forsum E (2005) Changes in basal metabolic rate during pregnancy in relation to changes in body weight and composition, cardiac output, insulin-like growth factor I, and thyroid hormones and in relation to fetal growth. Am J Clin Nutr 81:678–685PubMedGoogle Scholar
- 23.Chellakooty M, Vangsgaard K, Larsen T et al (2004) A longitudinal study of intrauterine growth and the placental growth hormone (GH)-insulin-like growth factor I axis in maternal circulation: association between placental GH and fetal growth. J Clin Endocrinol Metab 89:384–391PubMedCrossRefGoogle Scholar
- 36.von Kries R, Göbel U, Hachmeister A, Kaletsch U, Michaelis J (1996) Vitamin K and childhood cancer: a population based case-control study in Lower Saxony, Germany. BMJ 313:199–203Google Scholar