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Fetal growth and risk of childhood acute lymphoblastic leukemia: results from an Australian case-control study
E Milne1, J A Royle, N H de Klerk
1Centre for Child Health Research, Telethon Institute for Child Health Research, University of Western Australia, Perth, Western Australia, Australia. lizm@ichr.uwa.edu.au
Insights
Faster fetal growth, measured by optimal birth weight, is linked to increased risk of childhood acute lymphoblastic leukemia. This finding suggests accelerated growth, not just high birth weight, plays a role.
Area of Science:
- Pediatric Oncology
- Reproductive Epidemiology
- Growth Factor Biology
Background:
- Childhood acute lymphoblastic leukemia (ALL) is the most common childhood cancer.
- Intrauterine growth patterns may influence childhood cancer risk.
- The role of fetal growth in ALL etiology requires further investigation.
Purpose of the Study:
- To investigate the association between intrauterine growth and the risk of childhood acute lymphoblastic leukemia (ALL).
- To determine if accelerated fetal growth, independent of birth weight, is a risk factor for ALL.
Main Methods:
- Population-based case-control study in Australia (2003-2006).
- Included 347 childhood ALL cases and 762 controls (<15 years).
- Assessed proportion of optimal birth weight via maternal questionnaires and analyzed using logistic regression.
Main Results:
- A positive association was found between proportion of optimal birth weight and ALL risk (OR=1.18 per SD increase).
- The association persisted even in children without high birth weight, indicating accelerated growth is key.
- Similar associations were observed across sexes, age groups, and ALL subtypes.
Conclusions:
- Accelerated fetal growth, indicated by a higher proportion of optimal birth weight, is associated with an increased risk of childhood ALL.
- Findings support the hypothesis that insulin-like growth factors may be involved in the causal pathway of ALL.
- This study confirms previous research linking rapid fetal growth to subsequent ALL risk.
Abstract:
The relation between intrauterine growth and risk of childhood acute lymphoblastic leukemia was investigated in an Australian population-based case-control study that included 347 cases and 762 controls aged <15 years recruited from 2003 to 2006. Information on proportion of optimal birth weight, a measure of the appropriateness of fetal growth, was collected from mothers by questionnaire. Data were analyzed by using logistic regression. Risk of acute lymphoblastic leukemia was positively associated with proportion of optimal birth weight; the odds ratio for a 1-standard-deviation increase in proportion of optimal birth weight was 1.18 (95% confidence interval: 1.04, 1.35) after adjustment for the matching variables and potential confounders. This association was also present among children who did not have a high birth weight, suggesting that accelerated growth, rather than high birth weight per se, is associated with risk of acute lymphoblastic leukemia. Similar associations between proportion of optimal birth weight and acute lymphoblastic leukemia were observed for both sexes and across age groups and leukemia subtypes. Results of this study confirm earlier findings of a positive association between rapidity of fetal growth and subsequent risk of acute lymphoblastic leukemia in childhood, and they are consistent with a role for insulin-like growth factors in the causal pathway.
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