Case-control study of childhood leukaemia and cancer in Scotland: findings for neonatal intramuscular vitamin K

McKinney, Patricia A.; Juszczak, Edmund; Findlay, Elizabeth; Smith, Katrina

doi:10.1136/bmj.316.7126.173

Cited by 50 publications

(33 citation statements)

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“…administration of vitamin K accords with the majority of individual studies to have reported on this topic (Ekelund et al, 1993;Klebanoff et al, 1993;Olsen et al, 1994;Ansell et al, 1996;von Kries et al, 1996;Roman et al, 1997;McKinney et al, 1998;Passmore et al, 1998a, b) and with the results of an individual record-based pooled analysis of the six major case -control studies (Roman et al, 2002). The one exception is a study carried out in the former Northern Health region of England which, although it found no association for all childhood ALL (OR ¼ 1.20, 95% CI ¼ 0.75 -1.92, based on 207 cases), reported a statistically significantly raised OR for ALL diagnosed between 12 and 71 months of age (OR ¼ 1.79, 95% CI ¼ 1.02 -3.15, based on 144 cases) (Parker et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Analyses were confined to England and North Wales, as data were not collected in South Wales and findings for Scotland have been previously published (McKinney et al, 1998(McKinney et al, , 1999 syndrome; 168 who were the product of multiple pregnancies; and 280 who did not have a corresponding matched case or control (the majority were controls whose pseudodiagnosis age was less than 3 months -because their corresponding case was diagnosed under 3 months of age). After making these exclusions, 2530 cases and 4487 controls remained, 93% of the subjects whose obstetric notes were abstracted (Table 1).…”

Section: Subjectsmentioning

confidence: 99%

“…vitamin K were raised by Golding et al (1992) in their report associating i.m., but not oral, vitamin K with childhood leukaemia. Since then, most research has failed to find any statistically significant associations (Ekelund et al, 1993;Klebanoff et al, 1993;Olsen et al, 1994;Ansell et al, 1996;von Kries et al, 1996;Roman et al, 1997;McKinney et al, 1998;Passmore et al, 1998a, b), although Parker et al (1998) argued that i.m. vitamin K increases the risk of acute lymphoblastic leukaemia (ALL) diagnosed between 12 and 71 months of age.…”

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Vitamin K and childhood cancer: a report from the United Kingdom Childhood Cancer Study

et al. 2003

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The relationship between neonatal vitamin K received by the intramuscular (i.m.) route and the development of leukaemia or other cancers was investigated as part of a national case -control study of childhood cancer, using data abstracted from obstetric and neonatal records. The analyses included 2530 children diagnosed with cancer before 15 years of age, 1174 of whom had leukaemia and 4487 control children without cancer. Overall, 39% of cases and 42% of controls had records of i.m. vitamin K administration, while 24% of cases and 22% of controls had no record of whether or not they had received vitamin K. Using subjects who received i.m. vitamin K as the baseline group, our analyses found no association between the administration of i.m. vitamin K and either leukaemia or other cancers as a group. We conclude that there is no convincing evidence that neonatal vitamin K administration, irrespective of the route by which it is given, influences the risk of children developing leukaemia or any other cancer.

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confidence: 99%

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confidence: 99%

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Vitamin K and childhood cancer: a report from the United Kingdom Childhood Cancer Study

et al. 2003

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“…vitamin K prophylaxis became a controversial topic when Golding et al (1992) reported that children who received it by this route were almost three times as likely to develop leukaemia as children who received it orally or not at all. Although subsequent studies failed to confirm these findings (Ekelund et al, 1993;Klebanoff et al, 1993;Olsen et al, 1994;Ansell et al, 1996;von Kries et al, 1996;Roman et al, 1997;McKinney et al, 1998;Parker et al, 1998;Passmore et al, 1998a,b), inconsistencies in their results have left lingering doubts about the safety of I.M. administration (Kaufman, 1999).…”

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confidence: 99%

“…In order to investigate this topic in more depth, a pooled analysis of individual patient data from the six major case -control studies (Golding et al, 1992;Ansell et al, 1996;von Kries et al, 1996;Roman et al, 1997;McKinney et al, 1998;Parker et al, 1998;Passmore et al, 1998a) has been undertaken. The principal aims were to use consistent definitions of exposure and potential confounders to:…”

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Vitamin K and childhood cancer: analysis of individual patient data from six case–control studies

et al. 2002

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To investigate the hypothesis that neonates who receive intramuscular vitamin K are at an increased risk of developing cancer, particularly leukaemia, a pooled analysis of individual patient data from six case -control studies conducted in Great Britain and Germany has been undertaken. Subjects comprised 2431 case children diagnosed with cancer before 15 years of age and 6338 control children. The retrospective assessment of whether or not an individual baby received vitamin K is not straightforward. In many cases no record was found in stored medical notes and two types of analysis were therefore conducted; in the first it was assumed that where no written record of vitamin K was found it had not been given, and in the second, where no written record of administration was found, information on hospital policy and perinatal morbidity was used to 'impute' whether or not vitamin K had been given. In the first analysis, no association was found between neonatal administration of intramuscular. vitamin K and childhood cancer: odds ratios adjusted for mode of delivery, admission to special care baby unit and low birth weight were 1.09 (95% confidence interval 0.92 -1.28) for leukaemia and 1.05 (0.92 -1.20) for other cancers. In the second analysis, the adjusted odds ratios increased to 1.21 (1.02 -1.44) for leukaemia and 1.10 (0.95 -1.26) for other cancers. This shift did not occur in all studies, and when data from the hypothesis generating Bristol study were excluded, the adjusted odds ratios for leukaemia became 1.06 (0.89 -1.25) in the first analysis and 1.16 (0.97 -1.39) when data on prophylaxis imputed from hospital policy and perinatal morbidity were used. We conclude that whilst the broad nature of the diagnostic groups and the poor quality of some of the vitamin K data mean that small effects cannot be entirely ruled out, our analysis provides no convincing evidence that intramuscular vitamin K is associated with childhood leukaemia.

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Vitamin K prophylaxis and childhood cancer

Ross

Davies

2000

Med. Pediatr. Oncol.

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Case-control study of childhood leukaemia and cancer in Scotland: findings for neonatal intramuscular vitamin K

Abstract: Objective: To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers. Design: Population based case-control study with data abstracted from hospital records. Setting: Scotland.

Cited by 50 publications

References 15 publications

Vitamin K and childhood cancer: a report from the United Kingdom Childhood Cancer Study

Vitamin K and childhood cancer: a report from the United Kingdom Childhood Cancer Study

Vitamin K and childhood cancer: analysis of individual patient data from six case–control studies

Vitamin K prophylaxis and childhood cancer

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