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.


Key words: 
Case-control study; Children; Maternal; Perinatal; Risk factors; Solid malignancies

Prenatal and perinatal risk factors for solid childhood malignancies: A questionnaire-based study.

Recently,the evident change characteristic in malignant tumor incidence is the trend of rejuvenation.Because caner incidences of children and adolescents have increased rapidly,it has been widely concerned by researches in many countries.Some scholars think the increased caner incidences may be associated with exposures of pregnant women to various carcinogenic environmental factors during gestation and even the preconceptional period.The results of epidemiological investigation or animal experiments showed that there was correlation between caner development in offspring and exposures of them to radiation,smog,some medicine,alcohol,pesticide,organic solvent,heavy metals and some virus etc.in utero.Although there is still lack of relevant human data and definite evidences,the potential risk factors leading to caner development in the offspring due to exposures during the gestation and preconceptional period also increase continuously.Therefore,it is urgent affairs to study on etiology related caner development in the offspring and take effective measures to eliminate these risks during the gestation and preconceptional period,possessing a great meaning for reducing tumor incidence of children and even all people.

Research on correlation between exposure to environmental carcinogenic factors during pregnancy and development of children tumor and preventive strategy

Piao Feng-yuan

Papers

Research on correlation between exposure to environmental carcinogenic factors during pregnancy and development of children tumor and preventive strategy