Maternal and birth characteristics and childhood rhabdomyosarcoma: a report from the Children’s Oncology Group
- 248 Downloads
Previous assessments of childhood rhabdomyosarcoma have indicated maternal and birth characteristics may be associated with tumor development; however, much work remains to identify novel and confirm suspected risk factors. Our objective was to evaluate the associations between maternal and birth characteristics and childhood rhabdomyosarcoma.
This case–control study included 322 cases and 322 pair-matched controls. Cases were enrolled in a trial run by the Intergroup Rhabdomyosarcoma Study Group. Population-based controls were identified using random digit dialing and were individually matched to cases on race, sex, and age. Families of the case and control subjects participated in a telephone interview, which captured information on maternal characteristics (birth control use, number of prenatal visits, anemia, and abnormal bleeding during pregnancy) and birth characteristics [birth weight, preterm birth, and type of delivery (vaginal vs. cesarean)]. Conditional logistic regression models were used to calculate an odds ratio (OR) and 95 % confidence interval (CI) for each exposure, adjusted for age, race, sex, household income, and parental education. As the two most common histologic types of rhabdomyosarcoma are embryonal (n = 215) and alveolar (n = 66), we evaluated effect heterogeneity of these exposures.
The only characteristic that was associated with childhood rhabdomyosarcoma, and statistically significant, was abnormal vaginal bleeding during pregnancy (OR 1.75, 95 % CI 1.12–2.74). Birth control use (OR 1.45, 95 % CI 0.96–2.18), anemia during pregnancy (OR 1.27, 95 % CI 0.81–1.99), and preterm birth (OR 2.51, 95 % CI 0.74–8.49) were positively associated with childhood rhabdomyosarcoma, but were not statistically significant. Low birth weight [adjusted odds ratios (aOR) 4.46, 95 % CI 1.41–14.1] and high birth weight (aOR 2.41, 95 % CI 1.09–5.35) were strongly associated with alveolar rhabdomyosarcoma. However, these factors did not display significant effect heterogeneity between histologic types (p > 0.15 for all characteristics).
Overall, we found little evidence that these maternal and birth characteristics are strongly associated with childhood rhabdomyosarcoma.
KeywordsAbnormal vaginal bleeding Epidemiology Rhabdomyosarcoma Soft tissue sarcoma
This work was supported by US National Cancer Institute grants CA21244, CA24507, CA30318, CA30969, CA29139, and CA13539, and in part by Kurt Groten Family Research Scholars Award (P. Lupo).
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Ries L, Smith M, Gurney J et al (1999) Cancer incidence and survival among children and adolescents: United States SEER Program 1975–1995. NIH Pub. No. 99-4649. National Cancer Institute, SEER Program, Bethesda, MDGoogle Scholar
- 3.Gurney JG, Young JL Jr., Roffers SD, Smith MA, Bunin GR (1999) Soft tissue sarcomas. Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program 1975–1995. National Cancer Institute SEER ProgramGoogle Scholar
- 5.Ruymann FB, Maddux HR, Ragab A et al (1988) Congenital anomalies associated with rhabdomyosarcoma: an autopsy study of 115 cases. A report from the Intergroup Rhabdomyosarcoma Study Committee (representing the Children’s Cancer Study Group, the Pediatric Oncology Group, the United Kingdom Children’s Cancer Study Group, and the Pediatric Intergroup Statistical Center). Med Pediatr Oncol 16:33–39PubMedCrossRefGoogle Scholar
- 12.Lupo PJ, Zhou R, Skapek SX, Hawkins DS, Spector LG, Scheurer ME, Fatih Okcu M, Melin B, Papworth K, Erhardt EB, Grufferman S (2013) Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma: a report from the children’s oncology group. Int J Cancer 134(2):431–436Google Scholar