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Peri-gestational risk factors for pediatric brain tumors in Neurofibromatosis Type 1
Kimberly J Johnson1, Nancy L Zoellner1, David H Gutmann2
1Brown School, Washington University, St. Louis, MO 63130, United States.
Insights
Higher birth weight is linked to increased optic pathway glioma risk in children with Neurofibromatosis Type 1 (NF1). This study evaluated early-life factors and pediatric brain tumors (PBTs) in NF1 patients.
Area of Science:
- Pediatric Oncology
- Genetics
- Neuroscience
Background:
- Neurofibromatosis Type 1 (NF1) predisposes individuals to pediatric brain tumors (PBTs), particularly optic pathway gliomas (OPGs).
- Early-life developmental factors are implicated in PBT origins, but their association with PBTs in NF1 patients remains unevaluated.
- This study investigates peri-gestational characteristics and PBTs in the NF1 population.
Purpose of the Study:
- To evaluate associations between peri-gestational characteristics and PBTs in individuals with NF1.
- To identify potential early-life risk factors for OPG development in NF1 patients.
Main Methods:
- A cross-sectional study of 606 individuals under 18 with NF1, enrolled in the NF1 Patient Registry Initiative.
- Data collected via questionnaires and medical records included peri-gestational factors and PBT/OPG diagnoses.
- Cox proportional hazards regression analyzed associations between diagnoses and characteristics like birth weight, parental age, and smoking.
Main Results:
- No significant associations were found between most assessed peri-gestational characteristics and PBTs or OPGs.
- A significant positive association emerged between higher birth weight quartiles and OPG diagnoses.
- The fourth birth weight quartile (≥3915.5g) showed a 3.32-fold increased risk for OPGs compared to the first quartile (≤3020g).
Conclusions:
- Higher birth weight is associated with an increased risk of OPGs in individuals with NF1.
- These findings align with general population studies on PBTs, suggesting birth weight as a relevant factor.
- Further research may elucidate the mechanisms linking higher birth weight to OPG development in NF1.
Background:
Individuals with Neurofibromatosis Type 1 (NF1) are strongly predisposed to developing pediatric brain tumors (PBTs), especially optic pathway gliomas (OPGs). Although developmental factors have been implicated in the origins of PBTs in both human and animal studies, associations between early-life factors and PBTs have not been evaluated in individuals with NF1. Our objective was to evaluate associations between peri-gestational characteristics and PBTs in this population.
Methods:
We conducted a cross-sectional study, ascertaining questionnaire and medical record data for 606 individuals<18years old who enrolled in the NF1 Patient Registry Initiative (NPRI) from 6/9/2011-6/29/2015. One hundred eighty-four individuals had reported PBT diagnoses, including 65 who were identified with OPG diagnoses. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between PBT and OPG diagnoses and peri-gestational characteristics (prematurity, birth weight, parental age, plurality, family history of NF1, assisted reproductive technology, maternal vitamin supplementation, and parental smoking).
Results:
We observed no significant associations between any of the assessed characteristics and PBTs overall or OPGs with the exception of birth weight. After controlling for potential confounding variables, we observed a significant positive association between birth weight quartile and OPGs with a HR of 3.32 (95% CI 1.39-7.94) for the fourth (≥3915.5g) compared to the first (≤3020g) quartile (p for trend=0.001).
Conclusions:
Consistent with results for PBTs in the general population, these results suggest that higher birth weights increase OPG risk in individuals with NF1.
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