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American Journal of Epidemiology Advance Access published online on August 24, 2005
American Journal of Epidemiology, doi:10.1093/aje/kwi261
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved
Received January 5, 2005
Accepted April 29, 2005

Article

Associations between Three Types of Maternal Bacterial Infection and Risk of Leukemia in the Offspring

Matti Lehtinen 1*, Helga M. Ögmundsdottir 2, Aini Bloigu 3, Timo Hakulinen 4, Elina Hemminki 5, Margret Gudnadottir 6, Anne Kjartansdottir 6, Jorma Paavonen 7, Eero Pukkala 4, Hrafn Tulinius 2, Tuula Lehtinen 8, and Pentti Koskela 3

1 National Public Health Institute, Helsinki and Oulu, Finland; University of Tampere, Tampere, Finland
2 Icelandic Cancer Society, Reykjavik, Iceland; University of Iceland, Reykjavik, Iceland
3 National Public Health Institute, Helsinki and Oulu, Finland
4 Finnish Cancer Registry, Helsinki, Finland
5 Research and Development Centre for Health and Social Welfare, Helsinki, Finland
6 University of Iceland, Reykjavik, Iceland
7 University of Helsinki, Helsinki, Finland
8 University of Tampere, Tampere, Finland

* To whom correspondence should be addressed.
Matti Lehtinen, E-mail: llmale{at}uta.fi


  Abstract

A case-control study was nested within two maternity cohorts with a total of 7 million years of follow-up for assessment of the role of bacterial infections in childhood leukemia. Offspring of 550,000 mothers in Finland and Iceland were combined to form a joint cohort that was followed for cancer up to age 15 years during 1975-1997 through national cancer registries. For each index mother-case pair, three or four matched control mother-control pairs were identified from population registers. First-trimester serum samples were retrieved from mothers of 341 acute lymphoblastic leukemia cases and 61 other leukemia cases and from 1,212 control mothers. Sera were tested for antibodies to the genus Chlamydia, Helicobacter pylori, and Mycoplasma pneumoniae. Odds ratios and 95% confidence intervals, adjusted for sibship size, were calculated as estimates of relative risk. M. pneumoniae immunoglobulin M appeared to be associated with increased risk (odds ratio (OR) = 1.6), but the association lost statistical significance when the specificity of the immunoglobulin M was considered (OR = 1.5, 95% confidence interval: 0.9, 2.4). In Iceland, H. pylori immunoglobulin G was associated with increased risk of childhood leukemia in offspring (OR = 2.8, 95% confidence interval: 1.1, 6.9). Since H. pylori immunoglobulin G indicates chronic carriage of the microorganism, early colonization of the offspring probably differs between Iceland and Finland, two affluent countries.

Keywords: antibodies; case-control studies; child; Chlamydia; Helicobacter pylori; leukemia, lymphocytic, acute; Mycoplasma pneumoniae.
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