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Birth weight and other risk factors for acute leukemia in the Jerusalem Perinatal Study cohort
Ora Paltiel1, Susan Harlap, Lisa Deutsch
1Braun School of Public Health and Community Medicine, and Department of Hematology, Hadassah-Hebrew University, Jerusalem, Israel. ora@vms.huji.ac.il
Insights
Higher birth weight in children is linked to an increased risk of acute leukemia, particularly acute myeloid leukemia (AML). Perinatal factors influence childhood leukemia development, with varying associations by type.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Perinatal Health
Background:
- Childhood leukemia is a significant health concern.
- Understanding perinatal and parental risk factors is crucial for prevention and early detection.
- Birth weight is a key indicator of fetal development and may influence long-term health outcomes.
Purpose of the Study:
- To investigate the association between birth weight and sibling birth weight with acute leukemia risk.
- To explore the impact of other perinatal and parental factors on childhood leukemia.
- To differentiate risk factors for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL).
Main Methods:
- Utilized data from the Jerusalem Perinatal Study (1964-1976), a cohort of 88,829 offspring.
- Linked cohort data with Israel's Cancer Registry for leukemia diagnoses.
- Employed univariate and multivariate proportional hazards models to assess risk factors.
Main Results:
- A positive linear relationship was observed between birth weight and overall acute leukemia, and specifically AML.
- Higher birth weight (> or = 3,000g) was a significant predictor for ALL, particularly in males.
- The association between birth weight and AML was strongest in infants and females.
Conclusions:
- Birth weight is a significant risk factor for acute leukemia across infancy, childhood, and young adulthood.
- Perinatal factors contribute to childhood leukemia development, but their influence differs based on leukemia subtype.
- Further research into the specific mechanisms linking birth weight and leukemia is warranted.
Objectives:
To assess the effect of birth weight of children and their siblings and other perinatal/parental factors on the risk of acute leukemia.
Methods:
We linked data from the Jerusalem Perinatal Study, a population-based research cohort (n = 88,829) of offspring born 1964 to 1976, with Israel's Cancer Registry. Risk factors for acute leukemia were assessed using univariate and multivariate proportional hazards models.
Results:
Leukemias developed in 65 individuals [24 acute myeloid leukemias (AML) and 41 acute lymphoblastic leukemias (ALL)]. A positive linear relation was found between gender-adjusted birth weight and all leukemias [hazard ratio (HR) 1.85, 95% confidence interval (95% CI) 1.1-3.0] and AML (HR 2.9, 95% CI 1.3-6.4). The association between birth weight and AML was especially notable among infants (HR 8.14, 95% CI 1.8-38.9 for age 0 to 1 year) but was also observed among subjects ages >14 years at diagnosis. The relation was particularly strong among females (P = 0.001). Other risk factors for AML risk on univariate analysis were maternal origin, socioeconomic status, birth weight of sibling > 3,500 g, and family size. On multivariate analysis, only birth weight retained borderline significance (adjusted HR 2.38 per kg, 95% CI 1.0-5.7). Significant predictors for ALL in both univariate and multivariate analyses were male sex (adjusted HR 1.92, 95% CI 1.0-3.7) and birth weight categories > or = 3,000 g introduced into the model as nonlinear terms.
Conclusion:
Birth weight is associated with an increased risk of acute leukemia in infants, children, and young adults. Perinatal factors play a role in the development of childhood leukemias, but the patterns of association vary by leukemia type.
