Abstract
Objective
Fetal origins of adult disease are of major interest. Potential long-term effects of the intrauterine environment on offspring's health have long been studied. We aimed to evaluate the effect of maternal obesity on the long-term risk for childhood malignancies in the offspring.
Study Design
A population based cohort analysis was performed comparing the risk for long-term childhood malignancies (up to the age of 18 years) in children born to mothers with and without pre-gestational obesity (defined as maternal pre-pregnancy body mass index of 30 kg/m2 or more). Childhood malignancies were pre-defined based on ICD-9 codes, as recorded in the hospital medical files. Deliveries occurred between the years 1991-2014 in a tertiary medical center. Newborns with congenital malformations and children with benign tumors were excluded from the long term analyses. A Kaplan-Meier survival curve was constructed to compare cumulative oncological morbidity in both groups over time and a Cox proportional hazards model was used to control for confounders.
Results
During the study period 241,273 newborns met the inclusion criteria; 3268 of which were born to obese mothers. Offspring to obese mothers presented a significantly higher risk of several childhood (head and neck, vulva or vagina, ophthalmic, adrenal and brain; Table) as well as an increased risk for total childhood malignancies (OR=2.1, 95% CI 1.2-3.7; p=0.010). The cumulative incidences of total oncological morbidity, using a Kaplan-Meier survival curve, was significantly higher in offspring of obese mothers (Log rank test p=0.023; Figure). In the Cox regression model, while controlling for maternal age, maternal diabetes, preterm delivery and hypertensive disorders, pre-pregnancy obesity remained an independent risk factor for childhood malignancies in the offsprings (adjusted HR 1.9, 95% CI 1.1-3.4, p=0.028).
Conclusion
Maternal obesity may create an intrauterine environment that leads to an increased risk for childhood malignancies in the offspring’s.
Fetal origins of adult disease are of major interest. Potential long-term effects of the intrauterine environment on offspring's health have long been studied. We aimed to evaluate the effect of maternal obesity on the long-term risk for childhood malignancies in the offspring.
Study Design
A population based cohort analysis was performed comparing the risk for long-term childhood malignancies (up to the age of 18 years) in children born to mothers with and without pre-gestational obesity (defined as maternal pre-pregnancy body mass index of 30 kg/m2 or more). Childhood malignancies were pre-defined based on ICD-9 codes, as recorded in the hospital medical files. Deliveries occurred between the years 1991-2014 in a tertiary medical center. Newborns with congenital malformations and children with benign tumors were excluded from the long term analyses. A Kaplan-Meier survival curve was constructed to compare cumulative oncological morbidity in both groups over time and a Cox proportional hazards model was used to control for confounders.
Results
During the study period 241,273 newborns met the inclusion criteria; 3268 of which were born to obese mothers. Offspring to obese mothers presented a significantly higher risk of several childhood (head and neck, vulva or vagina, ophthalmic, adrenal and brain; Table) as well as an increased risk for total childhood malignancies (OR=2.1, 95% CI 1.2-3.7; p=0.010). The cumulative incidences of total oncological morbidity, using a Kaplan-Meier survival curve, was significantly higher in offspring of obese mothers (Log rank test p=0.023; Figure). In the Cox regression model, while controlling for maternal age, maternal diabetes, preterm delivery and hypertensive disorders, pre-pregnancy obesity remained an independent risk factor for childhood malignancies in the offsprings (adjusted HR 1.9, 95% CI 1.1-3.4, p=0.028).
Conclusion
Maternal obesity may create an intrauterine environment that leads to an increased risk for childhood malignancies in the offspring’s.
| Original language | English GB |
|---|---|
| Pages (from-to) | S386-S386 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |
