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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Research Articles

Infant Acute Leukemia and Maternal Exposures during Pregnancy

Maria S. Pombo-de-Oliveira and Sergio Koifman
Maria S. Pombo-de-Oliveira
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Sergio Koifman
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DOI: 10.1158/1055-9965.EPI-06-0031 Published December 2006
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    Figure 1.

    Distribution of cases and controls (ratio) by geographic regions, Brazil, 1999-2005.

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  • Table 1.

    Sociodemographic variables distribution, IAL cases and controls, Brazil, 1999-2005

    Cases (n = 202), n (%)Controls (n = 440), n (%)P
    Age at hospitalization (mo)
        0-15103 (51.0)262 (59.5)0.04
        16-2199 (49.0)178 (40.5)
    Sex
        Male100 (49.6)233 (53.0)0.488
        Female102 (50.4)207 (47.0)
    Race (skin color)*
        White106 (52.5)156 (35.6)0.004
        Intermediate58 (28.7)142 (32.2)
        Black38 (18.8)142 (32.2)
    Maternal age (y)
        <184 (2.0)39 (8.9)0.002
        18-2466 (32.7)185 (42.0)
        25-3499 (49.0)162 (36.8)
        >3533 (16.3)54 (12.3)
    Population density (residence area)
        <10,00011 (5.4)18 (4.0)0.001
        10,000-39,99928 (13.9)36 (8.2)
        40,000-99,99927 (13.4)52 (11.9)
        100,000-499,00050 (24.8)83 (18.9)
        500,000-1,000,00018 (8.9)39 (8.9)
        >1,000,00068 (33.7)212 (48.1)
    Geographic origin in Brazil
        Southeast117 (57.9)251 (57.1)0.001
        Northeast51 (25.2)104 (23.6)
        South24 (11.9)51 (11.6)
        Central plateau10 (5.0)34 (7.7)
    Mother education (y)
        <4104 (51.5)208 (47.2)0.001
        5-974 (36.6)198 (45.0)
        ≥1024 (11.9)34 (7.7)
    Monthly family income†
        <40099 (49.0)276 (62.7)0.001
        400-99950 (24.8)111 (25.2)
        1,000-1,99935 (17.3)42 (9.5)
        ≥2,00018 (8.9)11 (2.5)
    • ↵* According to Parra et al. (14).

    • ↵† In Real ($R, the Brazilian currency).

  • Table 2.

    Maternal exposures during pregnancy, IAL cases and controls, Brazil, 1999-2005

    IAL, n (%)Controls, n (%)Crude OR (95% CI)Adjusted OR (95% CI)*
    Tobacco37 (18.3)101 (23.0)0.75 (0.49-1.15)0.89 (0.631-1.25)
    Marijuana7 (3.5)17 (3.9)0.90 (0.37-2.20)0.87 (0.63-1.20)
    Pain relievers
        Dipyrone124 (61.4)228 (51.9)1.48 (1.05-2.08)1.45 (1.02-2.06)
        Others†50 (24.8)111 (25.2)0.97 (0.66-1.43)
    Antibiotics
        Amoxicillin25 (12.4)62 (14.1)0.86 (0.52-1.42)0.88 (0.63-1.25)
        Ciprofloxacilin (quinolone)5 (2.5)11 (2.5)0.99 (0.34-2.89)0.94 (0.32-2.77)
    Vitamins/iron supplement73 (36.1)169 (38.4)0.77 (0.52-1.14)0.90 (0.63-1.28)
    Folic acid28 (13.9)47 (10.7)1.35 (0.82-2.22)1.22 (0.73-2.05)
    Antiemetic18 (8.9)25 (5.7)1.62 (0.86-3.04)1.69 (0.87-3.28)
    Antifungic (metronidazole)38 (13.9)44 (10.1)1.45 (0.87-2.40)1.39 (0.82-2.34)
    Abortive drugs
        All‡40 (19.8)90 (20.5)0.96 (0.63-1.45)0.81 (0.53-1.25)
        Misoprostol6 (3.0)7 (1.8)1.28 (0.40-4.06)1.23 (0.38-4.02)
    Hormones§18 (8.9)4 (0.9)10.66 (3.56-31.94)8.76 (2.85-26.93)
    Herbal infusions4 (2.0)5 (1.1)1.76 (0.47-6.62)1.93 (0.49-7.58)
    Pesticides91 (45.3)119 (27.0)2.23 (1.58-3.16)2.18 (1.53-2.13)
    • ↵* Adjusted for sex, income, maternal age, and birth weight.

    • ↵† Paracetamol, aspirin, hyoscine, and codeine.

    • ↵‡ Misoprostol, herbal infusions, and other compounds used as abortive.

    • ↵§ Oral contraceptives, antiabortive progesterone treatment, and thyroid hormones.

  • Table 3.

    Hormonal intake during preconception and pregnancy and IAL according to MLL status, Brazil, 1999-2005

    Hormones intakeIAL, n (%)MLL+ve, n (%)MLL−ve, n (%)Controls, n (%)IAL vs controls, OR (95% CI)*MLL+ve vs controls, OR (95% CI)*MLL−ve vs controls, OR (95% CI)*
    Preconception†
        Present24 (12.2)14 (21.5)6 (7.7)23 (5.3)2.26 (1.21-4.21)3.34 (1.51-7.36)1.13 (0.40-3.14)
        Absent173 (87.8)51 (78.5)72 (92.3)409 (94.7)
    1st trimester
        Present17 (8.4)5 (7.4)4 (5.0)3 (0.7)11.35 (3.20-40.20)10.57 (2.33-47.91)7.55 (1.50-37.94)
        Absent185 (91.6)63 (92.6)76 (95.0)438 (99.3)
    2nd trimester
        Present7 (3.5)1 (1.5)2 (2.5)3 (0.7)4.49 (1.07-18.87)2.62 (0.15-17.56)3.52 (0.51-24.02)
        Absent195 (96.5)67 (98.5)78 (97.5)438 (99.3)
    3rd trimester
        Present6 (3.0)1 (1.5)3 (3.8)3 (0.7)2.32 (0.60-8.98)1.02 (0.10-9.93)3.94 (0.80-19.28)
        Absent196 (97.0)67 (98.5)77 (96.2)438 (99.3)
    • ↵* Reported hormonal intake 1 year before pregnancy.

    • ↵† MLL status and hormonal exposure OR (case-case approach) adjusted for sex, income, maternal age, and birth weight.

  • Table 4.

    Association of selected environmental exposures during pregnancy and MLL status, IAL cases, in a case-case analysis, Brazil, 1999-2005

    ExposureExposed and MLL+ve (n)Unexposed and MLL+ve (n)Exposed and MLL−ve (n)Unexposed and MLL−ve (n)Crude OR (95% CI)*Adjusted OR† (95% CI)
    Dipyrone472344341.58 (0.80-3.08)1.45 (0.75-2.86)
    Metronidazole12547722.29 (0.84-6.19)1.72 (0.64-4.58)
    Quinolones2651792.43 (0.21-27.41)2.25 (0.70-25.70)
    Hormones6574762.00 (0.54-7.42)1.88 (0.50-7.01)
    Misoprostol3172100.88 (0.12-6.21)0.44 (0.50-7.01)
    • ↵* Interaction OR between MLL gene status and selected exposures (case-only approach).

    • ↵† ORs for MLL gene status and selected exposures adjusted for sex, income, maternal age, and birth weight.

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Cancer Epidemiology Biomarkers & Prevention: 15 (12)
December 2006
Volume 15, Issue 12
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Infant Acute Leukemia and Maternal Exposures during Pregnancy
Maria S. Pombo-de-Oliveira and Sergio Koifman
Cancer Epidemiol Biomarkers Prev December 1 2006 (15) (12) 2336-2341; DOI: 10.1158/1055-9965.EPI-06-0031

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Infant Acute Leukemia and Maternal Exposures during Pregnancy
Maria S. Pombo-de-Oliveira and Sergio Koifman
Cancer Epidemiol Biomarkers Prev December 1 2006 (15) (12) 2336-2341; DOI: 10.1158/1055-9965.EPI-06-0031
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