摘要
Importance:Childhood solid tumors account for the highest proportion of childhood cancers and are one of the leading causes of death in childhood.However,their pathogenesis is unclear.Objective:To explore prenatal and perinatal risk factors for solid malignancies in children.Methods:We enrolled 71 consecutive pediatric patients (44 boys and 27 girls;median age,30 months) with solid tumors who were diagnosed and treated at our center from January 2013 to December 2016 as the case group.We also enrolled 211 age-and residence-matched healthy children (ratio of approximately 3:1 with the case group) as the control group.We conducted a questionnaire-based survey with the parents of these 282 children.Univariate and multivariate conditional logistic regression analyses of the collected data were performed.Results:Confirmed solid malignancies included neuroblastoma (n =32),rhabdomyosarcoma (n =18),retinoblastoma (n =7),renal tumors (n =3),and other tumors (n =11).Risk factors for solid childhood tumors in the univariate analysis were the parents' age,gravidity,parity,abortion history,vaginal bleeding,family history of malignancy,and prenatal use of folic acid or hematinics/iron supplements (P ＜ 0.05),and those in the multivariate analysis were higher parity (odds ratio [OR],2.482;95％ confidence interval [CI],1.521-4.048),family history of malignancy (OR,3.667;95％ CI,1.679-8.009),and prenatal use of hematinics/iron supplements (OR,2.882;95％ CI,1.440-5.767).In contrast,use of prenatal folic acid was protective (OR,0.334;95％ CI,0.160-0.694).Interpretation:A family history of malignancy,use of prenatal hematinics/iron supplements,and higher parity are risk factors for solid childhood tumors,whereas use of prenatal folic acid is a protective factor.
Importance:Childhood solid tumors account for the highest proportion of childhood cancers and are one of the leading causes of death in childhood.However,their pathogenesis is unclear.Objective:To explore prenatal and perinatal risk factors for solid malignancies in children.Methods:We enrolled 71 consecutive pediatric patients (44 boys and 27 girls;median age,30 months) with solid tumors who were diagnosed and treated at our center from January 2013 to December 2016 as the case group.We also enrolled 211 age-and residence-matched healthy children (ratio of approximately 3:1 with the case group) as the control group.We conducted a questionnaire-based survey with the parents of these 282 children.Univariate and multivariate conditional logistic regression analyses of the collected data were performed.Results:Confirmed solid malignancies included neuroblastoma (n =32),rhabdomyosarcoma (n =18),retinoblastoma (n =7),renal tumors (n =3),and other tumors (n =11).Risk factors for solid childhood tumors in the univariate analysis were the parents' age,gravidity,parity,abortion history,vaginal bleeding,family history of malignancy,and prenatal use of folic acid or hematinics/iron supplements (P ＜ 0.05),and those in the multivariate analysis were higher parity (odds ratio [OR],2.482;95％ confidence interval [CI],1.521-4.048),family history of malignancy (OR,3.667;95％ CI,1.679-8.009),and prenatal use of hematinics/iron supplements (OR,2.882;95％ CI,1.440-5.767).In contrast,use of prenatal folic acid was protective (OR,0.334;95％ CI,0.160-0.694).Interpretation:A family history of malignancy,use of prenatal hematinics/iron supplements,and higher parity are risk factors for solid childhood tumors,whereas use of prenatal folic acid is a protective factor.
