Cancer Causes & Control

, Volume 18, Issue 6, pp 655–663 | Cite as

Birthweight by gestational age and childhood cancer

  • Joachim Schüz
  • Michele R. Forman
Original Paper


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.


Birthweight Cancer etiology Childhood cancer Childhood leukemia Gestational age 



Acute lymphoblastic leukemia


Acute myeloblastic leukemia


Central nervous system


Non-Hodgkin’s lymphoma


Odds ratio


Confidence interval


Appropriate-for-gestational age


Large-for-gestational age


Small-for-gestational age



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.


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Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  1. 1.Institute of Cancer EpidemiologyDanish Cancer SocietyCopenhagenDenmark
  2. 2.Laboratory of Biosystems and Cancer, Center for Cancer ResearchNational Cancer InstituteBethesdaUSA
  3. 3.Department of EpidemiologyMD Anderson Cancer CenterHoustonUSA

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