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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Birth characteristics and risk of neuroblastoma in young children
Kevin Y Urayama1, Julie Von Behren, Peggy Reynolds
1Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA.
Insights
Prenatal and perinatal factors influence neuroblastoma risk, with variations based on infant age. Hispanic and "other" race/ethnicity show reduced risk, while postterm delivery and cesarean birth increase it.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Perinatal Medicine
Background:
- Neuroblastoma incidence peaks in infancy, suggesting critical prenatal or perinatal influences.
- Understanding these early-life factors is crucial for identifying neuroblastoma etiology.
- Population-based studies are essential for investigating risk factors in diverse groups.
Purpose of the Study:
- To investigate the association between prenatal and perinatal factors and neuroblastoma risk.
- To identify specific risk factors varying by age at diagnosis (infancy vs. 1-4 years).
- To compare risk across different racial/ethnic groups.
Main Methods:
- Population-based case-control study using California birth certificates (1988-1997).
- 508 neuroblastoma cases (diagnosed <5 years) and matched controls.
- Multivariate analyses to assess odds ratios (OR) and confidence intervals (CI) for various factors.
Main Results:
- Reduced neuroblastoma risk observed in Hispanic and "other" race/ethnicity compared to non-Hispanic Whites (OR=0.57, 0.56).
- Increased risk associated with postterm/high birth weight delivery in infants (OR=6.99).
- Elevated risk linked to cesarean delivery in children aged 1-4 (OR=1.72); reduced risk with multiple previous pregnancies in infants (OR=0.39).
Conclusions:
- Prenatal and perinatal factors demonstrate a significant association with neuroblastoma risk.
- Etiologic factors appear to be specific to the age at neuroblastoma diagnosis.
- Findings highlight the importance of considering delivery characteristics and maternal history in neuroblastoma research.
Abstract:
The peak incidence of neuroblastoma during infancy suggests that certain prenatal or perinatal factors may be etiologically important. In this population-based study, California birth certificates were identified for 508 (86%) neuroblastoma cases diagnosed at less than 5 years of age between 1988 and 1997. For each case, two controls, matched on date of birth and gender, were randomly selected from the statewide birth registry. Results of multivariate analyses showed a reduced risk for children of Hispanic (odds ratio (OR) = 0.57, 95% confidence interval (CI): 0.43, 0.76) and "other" (OR = 0.56, 95% CI: 0.37, 0.85) race/ethnicity, compared with non-Hispanic Whites. Postterm/high birth weight delivery was associated with an increased risk of neuroblastoma compared with term/normal birth weight delivery among infants (OR = 6.99, 95% CI: 1.07, 45.55), while preterm birth appeared suggestive of a reduced risk among children 1-4 years of age. For children in this age group, the risk of neuroblastoma was elevated for cesarean delivery compared with vaginal delivery (OR = 1.72, 95% CI: 1.21, 2.47), and, for infants, the risk was reduced if the mother had had multiple previous pregnancies (OR = 0.39, 95% CI: 0.22, 0.69). These data suggest that etiologic factors associated with the prenatal and perinatal periods may be specific to age at neuroblastoma diagnosis.
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