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Exposure to maternal smoking during pregnancy and risk of childhood cancer: a study using the Danish national registers

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Abstract

Purpose

The relation between maternal smoking during pregnancy and childhood cancer in the offspring remains uncertain. This paper uses Danish national registers, which have collected data prospectively on smoking and cancer, to investigate the association.

Methods

Smoking during pregnancy was ascertained from maternal self-reported data in the Danish National Patient Register. Index children were followed up from birth until the first of the following events: cancer diagnosis, death, emigration, day before 15th birthday, or end of follow-up. Smoking during pregnancy was considered as a binary variable (no smoking in pregnancy and smoking in pregnancy) and by amounts smoked (no smoking, cessation during pregnancy, ≤5, 6–10, or ≥11 cigarettes/day).

Results

Of the 801,867 children included in the study, 20 % were exposed to maternal smoking during pregnancy. Overall, the hazard ratio (HR) for childhood cancer for the exposed compared to the non-exposed was 0.91 [95 % confidence interval (CI) 0.78, 1.07]. Stratification by number of cigarettes also gave statistically nonsignificant inverse associations. There was a statistically significant increased risk of childhood cancer among children whose mothers reported smoking cessation in pregnancy (HR 1.46; 95 % CI 1.01, 2.10). Regarding specific cancer sites, maternal smoking in pregnancy was positively associated with the risk of eye cancers in childhood.

Conclusions

Our results do not provide evidence for an association between maternal smoking in pregnancy and childhood cancer overall. An increased risk of childhood cancer was seen for children whose mothers reported smoking cessation in pregnancy. Future research could employ biomarkers, such as cotinine, to validate maternal smoking status recorded in registers as, even if collected prospectively, this self-reported variable may be subject to reporting bias.

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Acknowledgments

This work was supported by a grant from the European Research Council [ERC-2010-StG No. 260242, the European Commission’s Seventh Framework Programme (FP7)], the Nordic Cancer Union (2012, 2013) and NordForsk (070331), the Danish Medical Research Council (Project Nos. 09-060229, 09-063494 and 09-072986), and the Swedish Council for Working Life and Social Research (Grant No. 2010-0092). Natalie Momen is also partly supported by a fellowship from Aarhus University.

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Authors and Affiliations

  1. Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus C, Denmark

    Natalie C. Momen, Jørn Olsen & Jiong Li

  2. Department of Epidemiology, University of California, Los Angeles, CA, USA

    Jørn Olsen

  3. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark

    Jørn Olsen & Jiong Li

  4. THL National Institute for Health and Welfare, Helsinki, Finland

    Mika Gissler

  5. Nordic School of Public Health NHV, Göthenburg, Sweden

    Mika Gissler

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  1. Natalie C. Momen
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  4. Jiong Li
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Correspondence to Natalie C. Momen.

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Momen, N.C., Olsen, J., Gissler, M. et al. Exposure to maternal smoking during pregnancy and risk of childhood cancer: a study using the Danish national registers. Cancer Causes Control 27, 341–349 (2016). https://doi.org/10.1007/s10552-015-0707-0

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  • DOI: https://doi.org/10.1007/s10552-015-0707-0

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