Fetal programming and Wilms tumor

Abstract

Background: The ‘fetal programming’ hypothesis has been evaluated in many adult diseases including cancer, but not for Wilms tumor. Wilms tumor has been related to high birthweight but little is known about other growth metrics such as a baby’s birth length, ponderal index, or placenta size, which can shed additional light on growth patterns. Methods: Cases of Wilms tumor (N=217) were taken from the Danish Cancer Registry, and controls (N=4,340) were randomly selected from the Population Register and matched to cases by sex and age. Linkage to the Medical Births Registry provided information on gestational factors and fetal growth measurements, while linkage to the Patient Register provided information on maternal and child health conditions. Results: Despite having typically normal to higher birthweights, Wilms tumor cases had smaller placentas (≤540g; Odds Ratio (OR) = 4.24; 95% Confidence Interval (CI) 1.84, 9.78) and a lower placenta to birthweight ratio (OR =1.81; 95% CI 1.17, 2.82, per 1 SD decrease). Small placentas were more common among Wilms cases without congenital anomalies (OR = 6.43; 95% CI 1.95, 21.21). Wilms tumor cases had a higher prevalence of high birth weight (>4000 g; OR = 1.57; 95% CI 1.11, 2.22), birth length 55cm or longer (OR = 1.74; 95% CI 1.09, 2.78), and being large for gestational age (OR = 1.79; 95% CI 1.08, 2.96). Conclusions: Our study corroborates earlier studies showing associations with high birthweight, and suggests associations between Wilms tumor and decreased placental size and low placenta-to-birthweight ratio.

Gestational risk factors and childhood cancers: A cohort study in Taiwan

“…Associations between pediatric cancers and parity have been attributed to increased risk of infectious conditions from having older siblings, or alternatively, variation in hormone levels between first and subsequent pregnancies . Furthermore, second‐born and subsequent babies have higher birth weights than first‐borns perhaps due to pregnancy‐induced uterine vascular remodeling leading to increased placental size in second pregnancies, and placenta size may also predict risk of some pediatric cancers …”

“…46 Furthermore, second-born and subsequent babies have higher birth weights than first-borns perhaps due to pregnancy-induced uterine vascular remodeling leading to increased placental size in second pregnancies, 47 and placenta size may also predict risk of some pediatric cancers. 48 Increased risk for ALL was seen with Cesarean section birth, although records did not allow us to determine the type of Cesarean (planned or emergency). Associations were previously reported with prelabor Cesarean delivery, 49 with the hypothesis that the elevated cortisol levels which occur with labor may eliminate preleukemic and leukemic cells (the "adrenal hypothesis" 50 ).…”

Ações De Educação Em Saúde No Tratamento Oncológico: Manejo Dos Efeitos Adversos E Prevenção Dos Agravos

“…O diagnóstico pré-operatório do nefroblastoma em adultos é difícil porque não há achados radiográficos específicos que permitam diferenciá-lo dos tumores renais adultos mais comuns. Histopatologicamente, não há diferença entre o tumor de Wilms em adultos e crianças (HECK, 2019;HUSZNO et al, 2013).…”

The Association Between High Birth Weight and Long-Term Outcomes—Implications for Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

“…One SR (81), two cohort studies (82,83), and 12 casecontrol studies (51,78,80,(84)(85)(86)(87)(88)(89)(90)(91)(92) reported on Wilm's tumor in childhood. The SR being of medium quality reported an increased risk for Wilm's tumor if birth weight >4,000 g as well as for LGA [OR 1.36 (95% CI 1.12-1.64) and OR 1.51 (95% CI 1.25-1.83)] (81).…”