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婴儿的分娩方式和儿童期淋巴细胞白血病的风险 - - 一项瑞典基于人口的队列研究

Christina-Evmorfia Kampitsi¹, Hanna Mogensen¹, Mats Heyman^2,3

¹Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

International journal of cancer

|July 4, 2025

概括

计划的剖腹产可能会增加儿童白血病的风险,特别是B细胞前体急性淋巴细胞白血病 (ALL). 即使考虑到瑞典儿童的母亲和怀孕因素,这种关联仍然存在.

科学领域:

儿科瘤学儿科瘤学
流行病学流行病学
产科产科产科产科产科

背景情况:

剖腹产 (CS) 率在全球范围内不断上升,往往超过医疗必要性.
关于CS分娩和儿童白血病风险的现有研究提出了相互矛盾的发现.
计划的CS与急性淋巴细胞白血病 (ALL) 风险增加之间的潜在联系需要进一步调查,考虑到潜在的混因素.

研究的目的:

在一个大规模的瑞典队列中调查分娩方式和童年ALL之间的关联.
为了确定母体和怀孕条件是否混了CS和ALL之间的关系.
为了阐明所有亚型的特定风险,按照计划的vs计划外的CS.

主要方法:

在1982-1989年和1999-2014年间在瑞典出生的儿童进行全国性队列研究 (n=2,442,330).
关于怀孕状况,分娩方式和童年ALL诊断 (<20岁) 的数据来自国家注册.
考克斯的比例危险回归分析被用来评估交付方式与ALL的关联,以混因子进行调整.

主要成果:

计划性CS与儿童ALL (HR=1.21) 的风险增加有关,主要是由B细胞前体ALL (HR=1.29) 驱动的.
这种增加的风险集中在男孩和在5岁或之前被诊断为ALL的儿童中.
计划性CS和ALL风险之间的关联在调整为孕产妇和产周因素后仍然显著;非计划性CS没有显示增加风险.

结论:

这项研究支持计划式剖腹产与瑞典儿童B细胞前体ALL风险增加之间的关联.
这种联系似乎独立于母亲和怀孕条件,这表明可能涉及其他生物机制.
需要进一步的研究来探索潜在的机制,如改变微生物暴露或出生期间的荷尔蒙变化.

关键词:

剖腹产是一个剖腹产.孩子孩子孩子孩子孩子孩子这种白血病是白血病.白血病,B细胞白血病.白血病,淋巴细胞性白血病.

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