Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts
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Common maternal infections during pregnancy and childhood leukaemia in the offspring : findings from six international birth cohorts. / He, Jian-Rong; Hirst, Jane E; Tikellis, Gabriella; Phillips, Gary S; Ramakrishnan, Rema; Paltiel, Ora; Ponsonby, Anne-Louise; Klebanoff, Mark; Olsen, Jørn; Murphy, Michael F G; Håberg, Siri E; Lemeshow, Stanley; Olsen, Sjurdur; Qiu, Xiu; Magnus, Per; Golding, Jean; Ward, Mary H; Wiemels, Joseph L; Rahimi, Kazem; Linet, Martha S; Dwyer, Terence.
I: International Journal of Epidemiology, 2022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Common maternal infections during pregnancy and childhood leukaemia in the offspring
T2 - findings from six international birth cohorts
AU - He, Jian-Rong
AU - Hirst, Jane E
AU - Tikellis, Gabriella
AU - Phillips, Gary S
AU - Ramakrishnan, Rema
AU - Paltiel, Ora
AU - Ponsonby, Anne-Louise
AU - Klebanoff, Mark
AU - Olsen, Jørn
AU - Murphy, Michael F G
AU - Håberg, Siri E
AU - Lemeshow, Stanley
AU - Olsen, Sjurdur
AU - Qiu, Xiu
AU - Magnus, Per
AU - Golding, Jean
AU - Ward, Mary H
AU - Wiemels, Joseph L
AU - Rahimi, Kazem
AU - Linet, Martha S
AU - Dwyer, Terence
N1 - © The Author(s) 2021; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Previous epidemiological studies have found positive associations between maternal infections and childhood leukaemia; however, evidence from prospective cohort studies is scarce. We aimed to examine the associations using large-scale prospective data.METHODS: Data were pooled from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA (recruitment 1950s-2000s). Primary outcomes were any childhood leukaemia and acute lymphoblastic leukaemia (ALL); secondary outcomes were acute myeloid leukaemia (AML) and any childhood cancer. Exposures included maternal self-reported infections [influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections and urinary tract infection (including cystitis)] and infection-associated symptoms (fever and diarrhoea) during pregnancy. Covariate-adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using multilevel Cox models.RESULTS: Among 312 879 children with a median follow-up of 13.6 years, 167 leukaemias, including 129 ALL and 33 AML, were identified. Maternal urinary tract infection was associated with increased risk of any leukaemia [HR (95% CI) 1.68 (1.10-2.58)] and subtypes ALL [1.49 (0.87-2.56)] and AML [2.70 ([0.93-7.86)], but not with any cancer [1.13 (0.85-1.51)]. Respiratory tract infection was associated with increased risk of any leukaemia [1.57 (1.06-2.34)], ALL [1.43 (0.94-2.19)], AML [2.37 (1.10-5.12)] and any cancer [1.33 (1.09-1.63)]; influenza-like illness showed a similar pattern but with less precise estimates. There was no evidence of a link between other infections and any outcomes.CONCLUSIONS: Urinary tract and respiratory tract infections during pregnancy may be associated with childhood leukaemia, but the absolute risk is small given the rarity of the outcome.
AB - BACKGROUND: Previous epidemiological studies have found positive associations between maternal infections and childhood leukaemia; however, evidence from prospective cohort studies is scarce. We aimed to examine the associations using large-scale prospective data.METHODS: Data were pooled from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA (recruitment 1950s-2000s). Primary outcomes were any childhood leukaemia and acute lymphoblastic leukaemia (ALL); secondary outcomes were acute myeloid leukaemia (AML) and any childhood cancer. Exposures included maternal self-reported infections [influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections and urinary tract infection (including cystitis)] and infection-associated symptoms (fever and diarrhoea) during pregnancy. Covariate-adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using multilevel Cox models.RESULTS: Among 312 879 children with a median follow-up of 13.6 years, 167 leukaemias, including 129 ALL and 33 AML, were identified. Maternal urinary tract infection was associated with increased risk of any leukaemia [HR (95% CI) 1.68 (1.10-2.58)] and subtypes ALL [1.49 (0.87-2.56)] and AML [2.70 ([0.93-7.86)], but not with any cancer [1.13 (0.85-1.51)]. Respiratory tract infection was associated with increased risk of any leukaemia [1.57 (1.06-2.34)], ALL [1.43 (0.94-2.19)], AML [2.37 (1.10-5.12)] and any cancer [1.33 (1.09-1.63)]; influenza-like illness showed a similar pattern but with less precise estimates. There was no evidence of a link between other infections and any outcomes.CONCLUSIONS: Urinary tract and respiratory tract infections during pregnancy may be associated with childhood leukaemia, but the absolute risk is small given the rarity of the outcome.
U2 - 10.1093/ije/dyab199
DO - 10.1093/ije/dyab199
M3 - Journal article
C2 - 34519790
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
SN - 0300-5771
ER -
ID: 306439967