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Case-control study of birth characteristics and the risk of hepatoblastoma
Julia E Heck1, Travis J Meyers, Christina Lombardi
1Department of Epidemiology, School of Public Health, University of California, 650 Charles E. Young Drive, Box 951772, Los Angeles, CA 90095-1772, USA. jeheck@ucla.edu
Insights
Hepatoblastoma risk is higher in infants with low birthweight, preterm birth, small size for gestational age, and multiple births. Pregnancy complications like preeclampsia also increase risk.
Area of Science:
- Pediatric Oncology
- Cancer Epidemiology
- Perinatal Health
Background:
- Hepatoblastoma is a rare embryonic tumor in young children.
- Etiology of hepatoblastoma remains largely unknown.
Purpose of the Study:
- To investigate the etiology of hepatoblastoma.
- To identify risk factors associated with hepatoblastoma development.
Main Methods:
- Matched California Cancer Registry records (1988-2007) with birth records for 261 hepatoblastoma cases.
- Utilized probabilistic record linkage and frequency-matched controls (n=218,277).
- Analyzed birth certificate data on demographics, birth characteristics, and pregnancy/newborn complications.
Main Results:
- Increased hepatoblastoma risk observed with low birthweight (OR=2.02), very low birthweight (OR=15.4), preterm birth <33 weeks (OR=7.27), small size for gestational age (OR=1.75), and multiple births (OR=2.52).
- Pregnancy complications linked to hepatoblastoma include preeclampsia, premature labor, fetal distress, and congenital anomalies.
Conclusions:
- Findings confirm associations between hepatoblastoma and low birthweight and preeclampsia.
- Multiple birth pregnancies may suggest a link to infertility treatments.
Background:
Hepatoblastoma is a malignant embryonal tumor typically diagnosed in children younger than five years of age. Little is known on hepatoblastoma etiology.
Methods:
We matched California Cancer Registry records of hepatoblastomas diagnosed in children younger than age 6 from 1988 to 2007 to birth records using a probabilistic record linkage program, yielding 261 cases. Controls (n=218,277), frequency matched by birth year to all cancer cases in California for the same time period, were randomly selected from California birth records. We examined demographic and socioeconomic information, birth characteristics, pregnancy history, complications in pregnancy, labor and delivery, and abnormal conditions and clinical procedures relating to the newborn, with study data taken from birth certificates.
Results:
We observed increased risks for hepatoblastoma among children with low [1500-2499 g, Odds Ratio (OR)=2.02, 95% confidence interval (CI) 1.29-3.15] and very low birthweight (<1500 g, OR=15.4, 95% CI 10.7-22.3), preterm birth <33 weeks (OR=7.27, 95% CI 5.00, 10.6), small size for gestational age (OR=1.75, 95% CI 1.25-2.45), and with multiple birth pregnancies (OR=2.52, 95% CI 1.54-4.14). We observed a number of pregnancy and labor complications to be related to hepatoblastoma, including preeclampsia, premature labor, fetal distress, and congenital anomalies.
Conclusion:
These findings confirm previously reported associations with low birthweight and preeclampsia. The relation with multiple birth pregnancies has been previously reported and may indicate a relation to infertility treatments.
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