Document Detail

Maternal smoking during pregnancy and risk for childhood leukemia: a nationwide case-control study in Greece and meta-analysis.
MedLine Citation:
PMID:  21990018     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Maternal smoking during pregnancy has been often implicated in the development of childhood leukemia with ambiguous results. Hence, we conducted a meta-analysis aiming to summarize current evidence and quantify any tentative impact.
PROCEDURE: We retrieved one cohort (553 leukemias compared to 1,440,542 children), 20 case-control studies and also analyzed the updated Greek case-control dataset with unpublished data, yielding in total 11,092 cases and 25,221 controls.
RESULTS: Odds ratios reported in the studies included ranged from 0.70 to 2.20 for acute lymphocytic (ALL) and from 0.60 to 2.17 for acute myelocytic leukemia (AML). The combined effect regarding the association of maternal smoking (any vs. no) and leukemia risk was 1.03 for ALL (95% CI = 0.95-1.12, random effects model) and 0.99 for AML (95% CI = 0.90-1.09, fixed effects model). The results remained unchanged when sensitivity analyses were undertaken of studies reporting same maternal smoking periods, those focusing only on childhood leukemia deaths or investigations which did not clearly define AML subtype.
CONCLUSIONS: The findings of the meta-analysis challenge the limits of traditional epidemiology to provide sound inferences when point estimates of constituent studies range around the null. In particular, this study provides no support to a hypothesis linking maternal smoking during pregnancy with subsequent development of main childhood leukemia subtypes. Further investigations employing molecular and genetic epidemiology, however, might be needed in the hope to reveal even minimal risks pertaining individuals with specific susceptibility to tobacco compounds who sustain high environmental exposures prenatally or postnatally.
Alexandra Klimentopoulou; Constantine N Antonopoulos; Charalampia Papadopoulou; Prodromos Kanavidis; Aristomenis-Dimitrios Tourvas; Sofia Polychronopoulou; Margarita Baka; Fani Athanasiadou-Piperopoulou; Maria Kalmanti; Vassiliki Sidi; Maria Moschovi; Eleni Th Petridou
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2011-10-11
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  58     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-01-11     Completed Date:  2012-02-28     Revised Date:  2013-01-09    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  344-51     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, 75 M. Asias Str., Goudi, Athens, Greece.
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MeSH Terms
Case-Control Studies
Child, Preschool
Greece / epidemiology
Infant, Newborn
Leukemia, Myeloid, Acute / epidemiology,  etiology*
Matched-Pair Analysis
Prenatal Exposure Delayed Effects / epidemiology,  etiology*
Smoking / adverse effects*,  epidemiology
Comment In:
Pediatr Blood Cancer. 2013 Jan;60(1):161-2   [PMID:  22623104 ]
Pediatr Blood Cancer. 2012 Mar;58(3):321-2   [PMID:  22102596 ]

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