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Preterm Birth and Subsequent Risk of Acute Childhood Leukemia: a Meta-Analysis of Observational Studies
Qi-Tao Huang1, Yun-Fei Gao, Mei Zhong
1Division of Obstetrics And Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Insights
Preterm birth (PTB) is linked to a higher risk of acute myeloid leukemia (AML) in children. However, the association between PTB and acute lymphoblastic leukemia (ALL) was not significant in this meta-analysis.
Area of Science:
- Pediatric Oncology
- Perinatal Epidemiology
- Public Health
Background:
- Preterm birth (PTB) is a known risk factor for non-communicable diseases.
- Previous studies on PTB and childhood leukemia risk are inconclusive.
- Investigating the PTB-leukemia link is crucial for understanding childhood cancer etiology.
Purpose of the Study:
- To systematically review and meta-analyze existing literature.
- To determine if PTB is associated with an increased risk of acute childhood leukemia.
- To examine the association for specific leukemia subtypes: ALL and AML.
Main Methods:
- Searched PubMed, Web of Science, and EMBASE databases up to December 2015.
- Included 12 studies on acute childhood leukemia, 8 on ALL, and 7 on AML.
- Calculated pooled odds ratios (OR) and 95% confidence intervals (CI) using Revman 5.3 and Stata 10.0.
Main Results:
- PTB significantly increased the risk of acute childhood leukemia (OR = 1.09, 95% CI = 1.02-1.17).
- PTB was significantly associated with increased risk of AML (OR = 1.42, 95% CI = 1.21-1.67).
- No significant association was found between PTB and ALL risk (OR = 1.04, 95% CI = 0.96-1.13).
Conclusions:
- Preterm birth is a risk factor for acute myeloid leukemia in children.
- The link between PTB and acute lymphoblastic leukemia requires further investigation.
- Additional research is needed to establish causality and understand biological mechanisms.
Background:
Preterm birth (PTB) has been recognized as a crucial long term risk factor for multiple non-communicable diseases. However, studies between the relationship of PTB and the risk of acute childhood leukemia have yielded inconclusive results. Therefore, we performed a meta-analysis to systematically review the current literature to investigate whether PTB is associated with increased risk of acute childhood leukemia.
Methods:
Three electronic databases (PubMed, Web of Science, and EMBASE) were searched up to December 1st, 2015. Relevant studies reporting the association between PTB and subsequent risk of acute childhood leukemia were included for further evaluation. Statistical analysis was performed using Revmen 5.3 and Stata 10.0.
Results:
A total of 12 studies for acute childhood leukemia, eight studies for acute lymphoblastic leukemia (ALL), and seven studies for acute myeloid leukemia (AML) were included in the current meta-analyses. We calculated pooled odds ratio (OR) and 95% confidence interval (CI) to evaluate the relationship between PTB and acute childhood leukemia as well as its two subtypes: ALL and AML. Our results suggested that PTB was significantly associated with increased risk of acute childhood leukemia (OR = 1.09, 95% CI = 1.02-1.17, P = 0.01) and AML (OR = 1.42, 95% CI = 1.21-1.67, P < 0.01). However, PTB was not significantly associated with an increased risk of ALL (OR = 1.04, 95% CI = 0.96-1.13, P = 0.29).
Conclusion:
Our data showed that PTB increased the risk of AML. Further studies are required to explore causality and dissect the biological mechanisms involved.
