Pre‐pregnancy obesity and childhood malignancies: A population‐based cohort study

Abstract

Condensation:The association between pre-pregnancy obesity and long-term risk for childhood malignancy. AbstractObjective: Exploring the effect of maternal obesity during pregnancy on the long-term health of offspring is of great importance. The aim of this study was to evaluate the association between maternal pre-pregnancy obesity and future risk of childhood malignancies. Study design:A population-based cohort analysis comparing the risk for long-term childhood malignancies (up to the age of 18 years) in children born to mothers with and without pre-pregnancy obesity (body mass index > 30) was conducted in July 2017. Childhood malignancies were predefined based on ICD-9 codes, as recorded in the hospital medical files. Children with congenital malformations and multiple gestations were excluded from the analysis. The Kaplan-Meier survival curve was constructed to compare cumulative oncological morbidity in both groups over time. The Cox proportional hazards model was used to control for confounders. Results:During the study period, 241 273 infants met the inclusion criteria; 3268 were born to mothers with pre-pregnancy obesity. Children of obese women had significantly increased risk for several childhood malignancies (including brain tumors) as well as increased risk for total hospitalizations with malignancy diagnoses, even after controlling for several confounders (adjusted HR 1.90, 95% CI 1.07-3.37, P = 0.028). Cumulative incidence of oncological morbidity was also significantly increased over time in the studied group (log-rank P = 0.023). Conclusion:Maternal pre-pregnancy obesity is significantly associated with an increased longterm risk for general childhood malignancies, and specifically brain tumors in the offspring. These results are important when counseling mothers regarding potential future risks and recommended lifestyle modifications. K E Y W O R D Sbrain tumor, childhood malignancy, intrauterine environment, pre-pregnancy obesity

Maternal Body Mass Index, Diabetes, and Gestational Weight Gain and Risk for Pediatric Cancer in Offspring: A Systematic Review and Meta-Analysis

“…Nine studies provided eligible prepregnancy BMI data ( Supplementary Table 1 , available online) ( 29-37 ). An additional 7 studies with maternal prepregnancy weight data were found but excluded because of vague obesity definitions/lack of ascertainment description ( 38 , 39 ), providing weight rather than BMI ( 40-42 ), or expressing BMI in categories that could not be converted into usable data ( 43 , 44 ). Eligible studies covered 3 404 747 participants and 14 706 childhood cancer patients across 5 countries.…”

Maternal Body Mass Index, Gestational Weight Gain, and Risk of Cancer in Offspring: A Systematic Review and Meta-Analysis

“…Based on a review of the full texts of 112 studies, 90 studies were excluded, mainly because they were reviews, nondescendant cancers, lack of information on maternal BMI or GWG, unclear or incomplete data, or duplicated data. Finally, twenty-two studies were identified as eligible and included in the present meta-analysis ( Figure 1 ) [ 13 , 14 , 15 , 16 , 20 , 21 , 22 , 23 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

“… Forest plot of the association between maternal BMI and the risk of total cancer in offspring [ 13 , 14 , 15 , 16 , 20 , 21 , 22 , 23 , 33 , 34 , 35 , 36 , 38 , 39 , 40 , 42 , 43 , 44 , 45 , 46 ]. …”

“…Mounting evidence suggests that maternal obesity may increase the risk of cancer in offspring. Meanwhile, a possible link is also observed between maternal gestational weight gain (GWG) and cancer risk in offspring [ 13 , 14 , 15 , 16 ]. Considering the relative prevalence of overweight/obesity in pregnant women (the prevalence of overweight/obesity women during pregnancy ranges from 12.3% to 63.5%) and the serious financial and health burden of cancer, even a small risk can lead to a severe disease burden [ 17 , 18 , 19 ].…”

“…Considering the relative prevalence of overweight/obesity in pregnant women (the prevalence of overweight/obesity women during pregnancy ranges from 12.3% to 63.5%) and the serious financial and health burden of cancer, even a small risk can lead to a severe disease burden [ 17 , 18 , 19 ]. However, the available evidence regarding maternal overweight/obesity and GWG and the risk of cancer in offspring is inconsistent [ 14 , 16 , 20 , 21 , 22 , 23 ]. In this situation, the use of comprehensive methods (for example, meta-analysis) to evaluate the data provided in scientific studies will help to clarify the relationship between maternal body mass index (BMI) and GWG and offspring cancer.…”