Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts
<p><strong>Background</strong></p> Previous epidemiological studies have found positive associations between maternal infections and childhood leukaemia; however, evidence from prospective cohort studies is scarce. We aimed to examine the associations using large-scale prospe...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| 其他作者: | |
| 格式: | Journal article |
| 語言: | English |
| 出版: |
Oxford University Press
2021
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| _version_ | 1826308476130820096 |
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| author | He, J-R Hirst, JE Tikellis, G Phillips, GS Ramakrishnan, R Paltiel, O Ponsonby, A-L Klebanoff, M Olsen, J Murphy, MFG Håberg, SE Lemeshow, S Olsen, SF Qiu, X Magnus, P Golding, J Ward, MH Wiemels, JL Rahimi, K Linet, MS Dwyer, T |
| author2 | International Childhood Cancer Cohort Consortium |
| author_facet | International Childhood Cancer Cohort Consortium He, J-R Hirst, JE Tikellis, G Phillips, GS Ramakrishnan, R Paltiel, O Ponsonby, A-L Klebanoff, M Olsen, J Murphy, MFG Håberg, SE Lemeshow, S Olsen, SF Qiu, X Magnus, P Golding, J Ward, MH Wiemels, JL Rahimi, K Linet, MS Dwyer, T |
| author_sort | He, J-R |
| collection | OXFORD |
| description | <p><strong>Background</strong></p>
Previous epidemiological studies have found positive associations between maternal infections and childhood leukaemia; however, evidence from prospective cohort studies is scarce. We aimed to examine the associations using large-scale prospective data.
<p><strong>Methods</strong></p>
Data were pooled from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA (recruitment 1950s-2000s). Primary outcomes were any childhood leukaemia and acute lymphoblastic leukaemia (ALL); secondary outcomes were acute myeloid leukaemia (AML) and any childhood cancer. Exposures included maternal self-reported infections [influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections and urinary tract infection (including cystitis)] and infection-associated symptoms (fever and diarrhoea) during pregnancy. Covariate-adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using multilevel Cox models.
<p><strong>Results</strong></p>
Among 312 879 children with a median follow-up of 13.6 years, 167 leukaemias, including 129 ALL and 33 AML, were identified. Maternal urinary tract infection was associated with increased risk of any leukaemia [HR (95% CI) 1.68 (1.10–2.58)] and subtypes ALL [1.49 (0.87–2.56)] and AML [2.70 ([0.93–7.86)], but not with any cancer [1.13 (0.85–1.51)]. Respiratory tract infection was associated with increased risk of any leukaemia [1.57 (1.06–2.34)], ALL [1.43 (0.94–2.19)], AML [2.37 (1.10–5.12)] and any cancer [1.33 (1.09–1.63)]; influenza-like illness showed a similar pattern but with less precise estimates. There was no evidence of a link between other infections and any outcomes.
<p><strong>Conclusions</strong></p>
Urinary tract and respiratory tract infections during pregnancy may be associated with childhood leukaemia, but the absolute risk is small given the rarity of the outcome. |
| first_indexed | 2024-03-07T07:20:05Z |
| format | Journal article |
| id | oxford-uuid:9db7f7d7-0249-4691-8c60-4f44ddd7600b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:20:05Z |
| publishDate | 2021 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:9db7f7d7-0249-4691-8c60-4f44ddd7600b2022-09-15T10:12:34ZCommon maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohortsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9db7f7d7-0249-4691-8c60-4f44ddd7600bEnglishSymplectic ElementsOxford University Press2021He, J-RHirst, JETikellis, GPhillips, GSRamakrishnan, RPaltiel, OPonsonby, A-LKlebanoff, MOlsen, JMurphy, MFGHåberg, SELemeshow, SOlsen, SFQiu, XMagnus, PGolding, JWard, MHWiemels, JLRahimi, KLinet, MSDwyer, TInternational Childhood Cancer Cohort Consortium<p><strong>Background</strong></p> Previous epidemiological studies have found positive associations between maternal infections and childhood leukaemia; however, evidence from prospective cohort studies is scarce. We aimed to examine the associations using large-scale prospective data. <p><strong>Methods</strong></p> Data were pooled from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA (recruitment 1950s-2000s). Primary outcomes were any childhood leukaemia and acute lymphoblastic leukaemia (ALL); secondary outcomes were acute myeloid leukaemia (AML) and any childhood cancer. Exposures included maternal self-reported infections [influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections and urinary tract infection (including cystitis)] and infection-associated symptoms (fever and diarrhoea) during pregnancy. Covariate-adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using multilevel Cox models. <p><strong>Results</strong></p> Among 312 879 children with a median follow-up of 13.6 years, 167 leukaemias, including 129 ALL and 33 AML, were identified. Maternal urinary tract infection was associated with increased risk of any leukaemia [HR (95% CI) 1.68 (1.10–2.58)] and subtypes ALL [1.49 (0.87–2.56)] and AML [2.70 ([0.93–7.86)], but not with any cancer [1.13 (0.85–1.51)]. Respiratory tract infection was associated with increased risk of any leukaemia [1.57 (1.06–2.34)], ALL [1.43 (0.94–2.19)], AML [2.37 (1.10–5.12)] and any cancer [1.33 (1.09–1.63)]; influenza-like illness showed a similar pattern but with less precise estimates. There was no evidence of a link between other infections and any outcomes. <p><strong>Conclusions</strong></p> Urinary tract and respiratory tract infections during pregnancy may be associated with childhood leukaemia, but the absolute risk is small given the rarity of the outcome. |
| spellingShingle | He, J-R Hirst, JE Tikellis, G Phillips, GS Ramakrishnan, R Paltiel, O Ponsonby, A-L Klebanoff, M Olsen, J Murphy, MFG Håberg, SE Lemeshow, S Olsen, SF Qiu, X Magnus, P Golding, J Ward, MH Wiemels, JL Rahimi, K Linet, MS Dwyer, T Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts |
| title | Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts |
| title_full | Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts |
| title_fullStr | Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts |
| title_full_unstemmed | Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts |
| title_short | Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts |
| title_sort | common maternal infections during pregnancy and childhood leukaemia in the offspring findings from six international birth cohorts |
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