Cancer Risk Among Children With Very Low Birth Weights

Abstract

Objective: Risk of hepatoblastoma is strongly increased among children with very low birth weight (VLBW: <1,500 grams). Because data on VLBW and other childhood cancers is sparse, we examined the risk of malignancy following VLBW in a large dataset. Methods: We combined case-control datasets created by linking the cancer and birth registries of California, Minnesota, New York, Texas, and Washington states, which comprised 17,672 children diagnosed with cancer at 0-14 years of age and 57,966 randomly selected controls. Unconditional logistic regression was used to examine the association of cancer with VLBW and moderately low birth weights (1,500-1,999g and 2,000-2,499g) compared to moderate/high birth weight (≥2,500) adjusting for sex, gestational age, birth order, plurality, maternal age, maternal race, state, and year of birth. Results: Most childhood cancers were not associated with low birth weights. However, retinoblastoma and gliomas other than astrocytomas and ependymomas were possibly associated with VLBW, with respective odds ratios (OR) of 2.43 (95% Confidence Interval (CI): 1.00-5.89) and 2.13 (95% CI: 0.71-6.39). Risk of other gliomas was also increased among children weighing 1,500-1,999g at birth (OR = 3.58; 95% CI: 1.98-6.47). For hepatoblastoma the ORs associated with birth weights of 2,000-2,499g, 1,500-1999g, and 350-1,499g were 1.56 (95% CI: 0.81-2.98), 3.37 (95% CI: 1.44-7.88), and 17.18 (95% CI: 7.46-39.54), respectively Conclusions: These data suggest no association between most cancers and VLBW with the exception of the known association with hepatoblastoma and possible moderately increased risks of other gliomas and retinoblastoma, which may warrant confirmation.

Fetal Growth, Preterm Birth, Neonatal Stress and Risk for CNS Tumors in Children: A Nordic Population- and Register-Based Case-Control Study

“…Being SGA has not previously been associated with CNS tumors, perhaps because of the small sample sizes in previous studies or differences in the definition of SGA (20). The higher risk we found for preterm birth is in line with a few previous studies (10,13,14) but not with those of smaller studies (11,(40)(41)(42), studies possibly affected by recall bias (11,(40)(41)(42), and the large U.S. study which used a less fine categorization of gestational age (15). It is unclear whether the association between preterm birth and risk for a CNS tumor is restricted to certain histologic subgroups.…”

“…Preterm birth and various indicators of neonatal stress have been investigated in small studies, with inconclusive results (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The hypothesis that increased risk for CNS tumors (16) and other cancers (17,18) are associated with high birth weight is supported by numerous studies.…”

Risk factors of childhood leukemia

“…13,14 However, we found no significant association between low birth weight and childhood leukemia (OR 1.5; 95%CI 0.25 to 8.98). In fact, we found a strong and the risk of childhood leukemia (OR 10.13; 95%CI 1.124 to 91.27).…”

Hepatoblastoma Etiopathogenesis

“…No environmental factors, parental tobacco or alcohol use, before and during pregnancy, or maternal illness or medication used during pregnancy have been clearly associated with HB development in the offspring [11,12]. Only very low birth weight (<1,500 g) has been significantly associated with HB [13], independently of gestational age. Because these premature infants are usually exposed to potentially toxic environmental agents in neonatal intensive care units (radiation, transfusions, medications, etc) at a time when, due to their immaturity, fetal tissues are more vulnerable to procarcinogenic insults, the role of an iatrogenic etiology for some cases of HB cannot be ruled out [14].…”