Maternal and Birth Characteristics and Childhood Embryonal Solid Tumors: A Population-Based Report from Brazil

Abstract

BackgroundSeveral maternal and birth characteristics have been reported to be associated with an increased risk of many childhood cancers. Our goal was to evaluate the risk of childhood embryonal solid tumors in relation to pre- and perinatal characteristics.MethodsA case-cohort study was performed using two population-based datasets, which were linked through R software. Tumors were classified as central nervous system (CNS) or non-CNS-embryonal (retinoblastoma, neuroblastoma, renal tumors, germ cell tumors, hepatoblastoma and soft tissue sarcoma). Children aged <6 years were selected. Adjustments were made for potential confounders. Odds ratios (OR) with 95% confidence intervals (CI) were computed by unconditional logistic regression analysis using SPSS.ResultsMales, high maternal education level, and birth anomalies were independent risk factors. Among children diagnosed older than 24 months of age, cesarean section (CS) was a significant risk factor. Five-minute Apgar ≤8 was an independent risk factor for renal tumors. A decreasing risk with increasing birth order was observed for all tumor types except for retinoblastoma. Among children with neuroblastoma, the risk decreased with increasing birth order (OR = 0.82 (95% CI 0.67–1.01)). Children delivered by CS had a marginally significantly increased OR for all tumors except retinoblastoma. High maternal education level showed a significant increase in the odds for all tumors together, CNS tumors, and neuroblastoma.ConclusionThis evidence suggests that male gender, high maternal education level, and birth anomalies are risk factors for childhood tumors irrespective of the age at diagnosis. Cesarean section, birth order, and 5-minute Apgar score were risk factors for some tumor subtypes.

Incidence of childhood cancer in Latin America and the Caribbean: coverage, patterns, and time trends

“…The observed overall increase in incidence of approximately 1% per year was documented in other studies over several decades, and decelerated recently in high-income settings ( 29 , 30 ). The modestly growing incidence rates may indicate changes in exposures, such as changing maternal and birth characteristics ( 31 ), or environmental risk factors ( 2 ). Nevertheless, improvements in the capacity to diagnose childhood cancer may have contributed to the increasing incidence of the CNS neoplasms, as diagnostic computed tomography and magnetic resonance imaging technology was introduced progressively in LAC during the study period ( 32 ).…”

Association between caesarean birth and childhood cancer: An age‐lagged approach

“…Distribution of characteristics at birth by caesarean, operative vaginal and spontaneous vaginal birth found that caesarean birth was associated with embryonal solid tumours after 2 years but not beforehand. 5 Similarly, a case-control study of 12 539 children suggested that caesarean birth was associated with the risk of neuroblastoma after 18 months of age only. 3 In contrast, a study of 5081 cases and 18 927 controls found that caesarean section was associated with the risk of acute lymphoblastic leukaemia between 2 and 4 years, but not at earlier or older ages.…”

“…1 The causes of most childhood cancers are poorly understood, but the young age of onset has led to the hypothesis that perinatal exposures including mode of delivery may be involved. [2][3][4][5] Caesarean section is linked with the risk of childhood cancer through the hygiene hypothesis. [6][7][8] Under the hygiene hypothesis, children born by caesarean bypass the birth canal and have reduced exposure to maternal vaginal and intestinal flora.…”

Insights into the Chemical Biology of Childhood Embryonal Solid Tumors by NMR-Based Metabolomics

“…Around 40% of all pediatric cancers account to solid tumors (Table 2) [28]. Many of them are so-called embryonal tumors, a heterogeneous group of cancers that exhibit in common a developmental origin from undifferentiated cells, and present histological features that resemble the forming fetus tissues [29]. Their genesis is likely based on arrest and/or defects in cellular pathways involved in cell growth and differentiation during pre-and post-natal periods, which result in retention of either embryonal or fetal tissue characteristics [30].…”

“…It is worth stating that high resolution magic angle spinning (HR-MAS) sample size can vary from 12 µL to 50 µL (depends on rotor that was used) and usually are around 15 mg [21] or 60 mg for the 4 mm rotors, liquid samples' size varies from 250 to 500 µL, and cancer cell lines usually report preparation procedures starting from 10 6 to 10 9 cells per sample for 4 mm 50 µL rotors. Some articles explored the small number of individuals because of the rarity of embryonal solid tumors, such as 5-15 samples, while cohorts with a greater number of individuals counted on 90-250 samples [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37].…”