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Published on: January 12, 2018
Maternal Obesity, Birth Size, and Risk of Childhood Cancer Development
Shaina L Stacy1,2, Jeanine M Buchanich3, Zhen-Qiang Ma4
1UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.
Insights
Maternal obesity and abnormal newborn size are linked to increased childhood cancer risk. These early-life factors, including fetal growth, play a significant role in cancer development, highlighting the importance of prenatal health.
Area of Science:
- Environmental Health
- Pediatric Oncology
- Epidemiology
Background:
- Infants and children are highly susceptible to environmental exposures during critical developmental windows.
- Maternal health and exposures before and during pregnancy can significantly impact a child's long-term health outcomes, including cancer risk.
Purpose of the Study:
- To investigate the association between maternal anthropometric characteristics (e.g., body mass index) and newborn size with the risk of childhood cancer.
- To identify potential early-life risk factors for childhood cancer development.
Main Methods:
- Linked Pennsylvania birth and childhood cancer registry data from 2003-2016.
- Analyzed a cohort of over 1.8 million births, assessing cancer diagnoses before age 14.
- Utilized statistical models to evaluate the relationship between maternal body mass index, newborn size, and cancer risk, controlling for known factors.
Main Results:
- Maternal body mass index (BMI) of 40 or higher was associated with a 57% increased risk of leukemia.
- Newborns larger than expected (≥30% above) had 2.2-fold and 1.8-fold increased hazard ratios for total childhood cancer and leukemia, respectively.
- Newborns smaller than expected (<30% below) also showed an increased risk for overall childhood cancer.
Conclusions:
- Maternal obesity and deviations in fetal growth (both large and small for gestational age) are significant risk factors for childhood cancer.
- Early-life exposures related to maternal obesity and fetal growth patterns contribute to childhood cancer development.
- These findings underscore the importance of monitoring maternal health and fetal growth during pregnancy to mitigate childhood cancer risks.
Abstract:
Infants and children are particularly vulnerable to in utero and early-life exposures. Thus, a mother's exposures before and during pregnancy could have important consequences for her child's health, including cancer development. We examined whether birth certificate-derived maternal anthropometric characteristics were associated with increased risk of subsequent childhood cancer development, accounting for established maternal and infant risk factors. Pennsylvania birth and cancer registry files were linked by the state Department of Health, yielding a virtual cohort of births and childhood cancers from 2003 through 2016. The analysis included 1,827,875 infants (13,785,309 person-years at risk), with 2,352 children diagnosed with any cancer and 747 with leukemia before age 14 years. Children born to mothers with a body mass index (weight (kg)/height (m)2) of ≥40 had a 57% (95% confidence interval: 12, 120) higher leukemia risk. Newborn size of ≥30% higher than expected was associated with 2.2-fold and 1.8-fold hazard ratios for total childhood cancer and leukemia, respectively, relative to those with expected size. Being <30% below expected size also increased the overall cancer risk (P for curvilinearity < 0.0001). Newborn size did not mediate the association between maternal obesity and childhood cancer. The results suggest a significant role of early-life exposure to maternal obesity- and fetal growth-related factors in childhood cancer development.
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