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Leukemia, non-Hodgkin's lymphoma, and Wilms tumor in childhood: the role of birth weight
Authors:Marina Rangel  Mônica Cypriano  Maria Lúcia de Martino Lee  Flávio Augusto Vercillo Luisi  Antonio Sérgio Petrilli  Maria Wany Louzada Strufaldi  Maria do Carmo Pinho Franco
Institution:1. Division of Nephrology, School of Medicine, Federal University of S?o Paulo, Rua Botucatu, 740, 04023-900, S?o Paulo, SP, Brazil
2. Methodist University of S?o Paulo, S?o Paulo, Brazil
3. Department of Pediatrics, School of Medicine, Federal University of S?o Paulo, S?o Paulo, Brazil
Abstract:There is emerging evidence that higher birth weight is associated with increased risk of cancer, in particular childhood leukemia. The purpose of this paper is to study whether this correlation is also significant with other childhood cancer. For this, we conducted a case–control study including 410 childhood cancer patients and 1,575 matched controls to investigate birth weight as a risk factor for leukemia, Wilms tumor, and non-Hodgkin's lymphoma. The estimated risk for all cancers has been found to be statistically and significantly higher in birth weight of more than 4,000 g (odds ratio, 2.50 and 95% confidence intervals (CI), 1.72–3.63). For leukemia, the estimated risk was 1.86 (95% CI, 1.04–3.30), for non-Hodgkin lymphoma, 1.99 (95% CI, 1.08–3.69), and being more remarkable for Wilms tumor, 4.76 (95% CI, 2.73–8.28). Moreover, moderate increased risk of both leukemia and non-Hodgkin lymphoma was also associated with birth weight between 3,000 and 3,999 g. High birth weight was associated with all cancers also when adjusted by gestational age, length at birth, and gender (odds ratio, 6.10 and 95% CI, 1.15–32.57). No associations were found for maternal alcohol consumption during pregnancy, maternal smoking, or smoking by other people at home or presence of obstetric variables (e.g., gestational diabetes, preeclampsia, and abruptio placentae). The present study supports the hypothesis that high birth weight is an independent risk factor for childhood Wilms tumor, leukemia, and non-Hodgkin lymphoma. Further studies should explore biological reasons to explain this relationship and, ultimately, to expand our knowledge about prenatal influences on the occurrence of this disease.
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