A case–control study of sporadic retinoblastoma in relation to maternal health conditions and reproductive factors: a report from the Children’s Oncology group

Abstract

BackgroundThe early age at retinoblastoma occurrence, the most common eye malignancy in childhood, suggests that perinatal factors may contribute to its etiology.MethodsIn a large multicenter study of non-familial retinoblastoma, we conducted structured interviews with the parents of 280 cases and 146 controls to elicit information on health during the perinatal period. We used unconditional logistic regression to assess associations between retinoblastoma and parental fertility treatment, birth control use in the year prior to pregnancy, maternal health conditions and the use of prescription medications during pregnancy, and whether mothers breastfed the index child.ResultsBilateral retinoblastoma was related to maternal underweight (body mass index <18.5) prior to pregnancy [Odds Ratio (OR) = 4.5, 95 % confidence interval (CI) 1.0, 20]. With regards to unilateral retinoblastoma, we observed a negative association with the use of condoms in the year prior to pregnancy (OR = 0.4, CI 0.2, 0.9), and a trend towards a positive association with maternal diabetes (OR = 2.2, CI 0.8, 6.6).ConclusionsResults from our study suggest a role for several maternal health and reproductive factors. Given that there are few epidemiologic studies of retinoblastoma, our results require replication in studies which utilize medical record review.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1773-0) contains supplementary material, which is available to authorized users.

Maternal pre-pregnancy and gestational diabetes, obesity, gestational weight gain, and risk of cancer in young children: a population-based study in California

“…No studies to date have published on Wilms’ tumor in relation to pre-pregnancy diabetes. Of the few studies that have specifically reported on gestational diabetes, several have found positive associations [ORs ranging from 2 to 3] with leukemia [18, 20, 21], and others have found no associations with hepatoblastoma and retinoblastoma [23, 24]. We found that several point estimates were elevated for gestational diabetes, but confidence intervals were too wide to draw conclusions from our results.…”

“…The few studies that have assessed the relation between pre-pregnancy BMI and childhood cancer risk have produced conflicting and inconclusive results [6, 15, 16, 23–26]. Given the unexpected pattern of a greater risk of these cancers with overweight but a drop in risk with obesity, it is notable that two studies of leukemia and retinoblastoma also observed an attenuation of the size of the estimate in the obese group [24, 26]. This may be explained by an increased risk of competing outcomes that cause selective survival of affected fetuses specifically fetal death, stillbirth, and neonatal, perinatal, and infant deaths that have been consistently observed to be associated with higher BMI.…”

Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis

“… 8 Moderate Greenop, 2015, Australia [ 64 ] 2003–2006;2005–2010 PC-CS 592/1389 0–14 Aus-ALL and Aus-CBT Population ALL ( N = 314); brain tumors ( N = 278) Never/< 3/3- < 6/≥ 6; Ever vs. never Questionnaire to mothers Matched: age, sex, and state of residence.Adjusted: Matched variables, maternal education, maternal age at birth, birth order, proportion of optimum birth weight. 7 Moderate Heck, 2015, USA and Canada [ 65 ] 2006–2011 HC-CS 243/134 0–15 Wills Eye Hospital in Philadelphia, or the Children’s Oncology Group Friends or unrelated children of case family Retinoblastoma ( N = 243) < 1/1–6/7–11/≥ 12; Ever vs. never Telephone interview of parents Matched: age.Adjusted: child’s age at interview, mother’s race/ethnicity, mother’s educational attainment, and household income. 7 Moderate Amitay, 2016, Israeli [ 66 ] 2005–2013 PC-CS 178/357 1–18 The hematologic departments of five large Israeli hospitals Population Leukemia ( N = 117); lymphoma ( N = 61) ≤ 6 vs. > 6 Interview of mothers Matched: age, gender, and spoken language.Adjusted: none.…”

Medical radiation exposure and risk of sporadic retinoblastoma

“…The remaining cases are considered sporadic; these children can have bilateral or unilateral diesease 1 . In sporadic bilateral retinoblastoma, a de novo germline alteration in RB1 occurs in the egg or sperm cell prior to conception and the second alteration occurs somatically after conception 2‐4 . In sporadic unilateral retinoblastoma, both alterations in RB1 occur after conception in somatic cells of the developing retina, although up to 15% can be caused by germline alterations 3,4 .…”

“…In sporadic bilateral retinoblastoma, a de novo germline alteration in RB1 occurs in the egg or sperm cell prior to conception and the second alteration occurs somatically after conception 2‐4 . In sporadic unilateral retinoblastoma, both alterations in RB1 occur after conception in somatic cells of the developing retina, although up to 15% can be caused by germline alterations 3,4 . Prior studies have shown an estimated 85% of de novo germline alterations in sporadic bilateral retinoblastoma are of paternal origin 5 .…”