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Fetal growth, preterm birth, neonatal stress and risk for CNS tumors in children: a Nordic population- and register-based case-control study.
Cancer Epidemiol Biomarkers Prev. 2010 Apr; 19(4):1042-52.CE

Abstract

BACKGROUND

The peak incidence of central nervous system (CNS) tumors in childhood indicates that intrauterine or neonatal characteristics are potential risk factors or symptoms of early onset of disease.

METHODS

We conducted a registry-based case-control study nested in the childhood populations of Denmark, Finland, Sweden, and Norway on the association between indicators of fetal growth and neonatal stress and childhood CNS tumor risk diagnosed during the period 1985-2006. Each of the 3,443 cases was matched individually on date of birth, sex, and country to five controls sampled randomly from population registries. Information on birth characteristics was obtained from national birth registries. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) by conditional logistic regression analyses.

RESULTS

We observed a U-shaped relation between risk for CNS tumors and birthweight, at >4.5 kg (OR, 1.27; 95% CI, 1.03-1.55) and <2.0 kg (OR, 1.50; 95% CI, 1.13-1.99), the latter being attenuated after adjustment for gestational age. Moreover, small-for-gestational age (OR, 1.28; 95% CI, 0.98-1.66) and large-for-gestational age (OR, 1.26; 95% CI, 1.02-1.55) were both associated with CNS tumors. The OR for preterm births was increased per 1-week decrease in gestational age (OR, 1.58; 95% CI, 1.04-2.44). Increased ORs were also observed for head circumference >38 cm (1.80; 95% CI, 1.18-2.74), 5-minute Apgar score <7 (1.44; 95% CI, 0.98-2.12), and breech presentation (1.33; 95% CI, 1.04-1.69). The observed associations varied little by histologic subgroup.

CONCLUSIONS

This study supports intrauterine or neonatal onset of childhood CNS tumors. The findings provide insight into the natural history of childhood CNS tumors indicating an early onset or, alternatively, potentially harmful exposures in the neonatal period that might be preventable.

Authors+Show Affiliations

Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark. samsoe@cancer.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20332267

Citation

Schmidt, Lisbeth Samsø, et al. "Fetal Growth, Preterm Birth, Neonatal Stress and Risk for CNS Tumors in Children: a Nordic Population- and Register-based Case-control Study." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 19, no. 4, 2010, pp. 1042-52.
Schmidt LS, Schüz J, Lähteenmäki P, et al. Fetal growth, preterm birth, neonatal stress and risk for CNS tumors in children: a Nordic population- and register-based case-control study. Cancer Epidemiol Biomarkers Prev. 2010;19(4):1042-52.
Schmidt, L. S., Schüz, J., Lähteenmäki, P., Träger, C., Stokland, T., Gustafson, G., Hjalgrim, L., Sehested, A., Johansen, C., & Schmiegelow, K. (2010). Fetal growth, preterm birth, neonatal stress and risk for CNS tumors in children: a Nordic population- and register-based case-control study. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 19(4), 1042-52. https://doi.org/10.1158/1055-9965.EPI-09-1273
Schmidt LS, et al. Fetal Growth, Preterm Birth, Neonatal Stress and Risk for CNS Tumors in Children: a Nordic Population- and Register-based Case-control Study. Cancer Epidemiol Biomarkers Prev. 2010;19(4):1042-52. PubMed PMID: 20332267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fetal growth, preterm birth, neonatal stress and risk for CNS tumors in children: a Nordic population- and register-based case-control study. AU - Schmidt,Lisbeth Samsø, AU - Schüz,Joachim, AU - Lähteenmäki,Päivi, AU - Träger,Catarina, AU - Stokland,Tore, AU - Gustafson,Göran, AU - Hjalgrim,Lisa, AU - Sehested,Astrid, AU - Johansen,Christoffer, AU - Schmiegelow,Kjeld, Y1 - 2010/03/23/ PY - 2010/3/25/entrez PY - 2010/3/25/pubmed PY - 2010/7/10/medline SP - 1042 EP - 52 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 19 IS - 4 N2 - BACKGROUND: The peak incidence of central nervous system (CNS) tumors in childhood indicates that intrauterine or neonatal characteristics are potential risk factors or symptoms of early onset of disease. METHODS: We conducted a registry-based case-control study nested in the childhood populations of Denmark, Finland, Sweden, and Norway on the association between indicators of fetal growth and neonatal stress and childhood CNS tumor risk diagnosed during the period 1985-2006. Each of the 3,443 cases was matched individually on date of birth, sex, and country to five controls sampled randomly from population registries. Information on birth characteristics was obtained from national birth registries. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) by conditional logistic regression analyses. RESULTS: We observed a U-shaped relation between risk for CNS tumors and birthweight, at >4.5 kg (OR, 1.27; 95% CI, 1.03-1.55) and <2.0 kg (OR, 1.50; 95% CI, 1.13-1.99), the latter being attenuated after adjustment for gestational age. Moreover, small-for-gestational age (OR, 1.28; 95% CI, 0.98-1.66) and large-for-gestational age (OR, 1.26; 95% CI, 1.02-1.55) were both associated with CNS tumors. The OR for preterm births was increased per 1-week decrease in gestational age (OR, 1.58; 95% CI, 1.04-2.44). Increased ORs were also observed for head circumference >38 cm (1.80; 95% CI, 1.18-2.74), 5-minute Apgar score <7 (1.44; 95% CI, 0.98-2.12), and breech presentation (1.33; 95% CI, 1.04-1.69). The observed associations varied little by histologic subgroup. CONCLUSIONS: This study supports intrauterine or neonatal onset of childhood CNS tumors. The findings provide insight into the natural history of childhood CNS tumors indicating an early onset or, alternatively, potentially harmful exposures in the neonatal period that might be preventable. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/20332267/Fetal_growth_preterm_birth_neonatal_stress_and_risk_for_CNS_tumors_in_children:_a_Nordic_population__and_register_based_case_control_study_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=20332267 DB - PRIME DP - Unbound Medicine ER -