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American Journal of Epidemiology Advance Access originally published online on May 28, 2009
American Journal of Epidemiology 2009 170(2):221-228; doi:10.1093/aje/kwp117
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Fetal Growth and Risk of Childhood Acute Lymphoblastic Leukemia: Results From an Australian Case-Control Study

E. Milne, J. A. Royle, N. H. de Klerk, E. Blair, H. Bailey, C. Cole, J. Attia, R. J. Scott and B. K. Armstrong

Correspondence to Dr. Elizabeth Milne, Telethon Institute for Child Health Research, P.O. Box 855, Perth, Western Australia, 6872 (e-mail: lizm{at}ichr.uwa.edu.au).

Received for publication December 16, 2008. Accepted for publication April 10, 2009.

The relation between intrauterine growth and risk of childhood acute lymphoblastic leukemia was investigated in an Australian population-based case-control study that included 347 cases and 762 controls aged <15 years recruited from 2003 to 2006. Information on proportion of optimal birth weight, a measure of the appropriateness of fetal growth, was collected from mothers by questionnaire. Data were analyzed by using logistic regression. Risk of acute lymphoblastic leukemia was positively associated with proportion of optimal birth weight; the odds ratio for a 1-standard-deviation increase in proportion of optimal birth weight was 1.18 (95% confidence interval: 1.04, 1.35) after adjustment for the matching variables and potential confounders. This association was also present among children who did not have a high birth weight, suggesting that accelerated growth, rather than high birth weight per se, is associated with risk of acute lymphoblastic leukemia. Similar associations between proportion of optimal birth weight and acute lymphoblastic leukemia were observed for both sexes and across age groups and leukemia subtypes. Results of this study confirm earlier findings of a positive association between rapidity of fetal growth and subsequent risk of acute lymphoblastic leukemia in childhood, and they are consistent with a role for insulin-like growth factors in the causal pathway.

birth weight; case-control studies; child; fetal development; leukemia; precursor cell lymphoblastic leukemia-lymphoma

Abbreviations: ALL, acute lymphoblastic leukemia; IGF-I, insulin-like growth factor I; POBW, proportion of optimal birth weight


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