American Journal of Epidemiology Vol. 143, No. 10: 996-1001
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Gravid Health Status, Medication Use, and Risk of Neuroblastoma
1Roswell Park Cancer Institute Buffalo, NY
2Department of Social and Preventive Medicine, State University of New York Buffalo, Buffalo, NY
3University of Massachusetts Amherst, MA
4New York State Department of Health Albany, NY
Reprint requests to Dr. Arthur M. Michalek, Department of Educational Affairs, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263-0001.
The epidemiology of neuroblastoma suggests that prenatal exposures may be important etiologic factors in this disease. The authors describe the role of maternal health status and prenatal medication usage and risk of neuroblastoma. This retrospective study was based on completed interviews with 183 histologically confirmed neuroblastoma cases aged 0–14 years diagnosed among residents of New York State (excluding New York City) between 1976 and 1987. Controls were matched to cases on year of birth and race and were drawn from the New York State live birth certificate registry. Interviews were satisfactorily completed with 85% of the cases and 87% of controls. Significantly elevated odds ratios were noted for vaginal infections during pregnancy (odds ratio (OR) = 2.2, 95% confidence interval (CI) 1.2–4.0), medical treatments for vaginal infection during pregnancy (OR = 2.4, 95% CI 1.2–4.9), and any reported use of sex hormones during pregnancy (OR = 3.0, 95% CI 1.3–6.9). Point estimates for any hormone use suggested elevated risk among male offspring (OR = 4.4, 95% CI 1.5–13.3). Among the individual exposures comprising any hormone use, only hormone use related to infertility was observed to be significant (OR = 10.4, 95% CI 1.2–89.9). A protective effect was noted for self-reported vitamin use (OR = 0.28, 95% CI 0.03–0.69). Although it is not possible to presume a specific role for prenatal hormone exposure as initiator or promoter, these findings lend support to an association between prenatal hormone exposure and risk of neuroblastoma.
case-control studies; child; hormones; neoplasms; neuroblastoma
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