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Am J Epidemiol 2004; 159:721-731.
Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Maternal Medication Use and Neuroblastoma in Offspring

Michael N. Cook1, Andrew F. Olshan1 , Harry A. Guess1, David A. Savitz1, Charles Poole1, Julie Blatt2, Melissa L. Bondy3 and Brad H. Pollock4

1 Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
2 Division of Pediatric Hematology/Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
3 Department of Epidemiology, M. D. Anderson Cancer Center, University of Texas, Houston, TX.
4 Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX.

The association between a mother’s use of specific medications during pregnancy and lactation and neuroblastoma in her offspring was evaluated in a case-control study. Newly diagnosed cases of neuroblastoma (n = 504) in the United States and Canada were identified between 1992 and 1994 at 139 hospitals affiliated with the Pediatric Oncology Group or the Children’s Cancer Group clinical trial programs. One age-matched control was sampled from the community of each case by means of random digit dialing. Exposure information was ascertained retrospectively from mothers in a structured telephone interview. Odds ratios were estimated using conditional logistic regression, with adjustment for maternal sociodemographic factors. The results did not support an association between neuroblastoma and maternal exposure to diuretic agents, antiinfective agents, estrogens, progestins, sedatives, anticonvulsant drugs, or drugs that may form N-nitroso derivatives. Mothers of cases were more likely to report using medications containing opioid agonists while they were pregnant or nursing than were mothers of controls (odds ratio = 2.4, 95% confidence interval: 1.3, 4.3). Specifically, more mothers of cases reported using medications containing codeine while pregnant or nursing than did mothers of controls (odds ratio = 3.4, 95% confidence interval: 1.4, 8.4). This preliminary finding may be due to bias, confounding, or chance, and additional studies are needed for confirmation.

case-control studies; child; codeine; neuroblastoma; pregnancy; risk factors

Abbreviations: Abbreviations: CI, confidence interval; OR, odds ratio; RDD, random digit dialing.


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