Caesarean sections, prenatal and postnatal conditions and childhood acute lymphoblastic leukaemia: A case-control study in the State of São Paulo, Brazil

• Published in: Cancer epidemiology Vol. 69; p. 101851
• Main Authors: Junqueira, Maria Elizangela Ramos, de Oliveira, Claúdia T., Tone, Luiz G., Lee, Maria Lúcia de M., de Andréa, Maria Lydia M., Bruniera, Paula, Epelman, Sidnei, Odone Filho, Vicente, Bonilha, Eliana de A., de Freitas, Marina, Okamura, Mirna N., Vico, Eneida R., Stevens, Anthony P., Rabello Neto, Dácio de L, Wünsch Filho, Victor
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2020; Elsevier Limited
• Subjects: Acute lymphoblastic leukemia; Adolescent; Adult; Age; Birth weight; Births; Brazil; Caesarean section; Cancer; Case-Control Studies; Case-control study; Cesarean section; Cesarean Section - statistics & numerical data; Child; Child, Preschool; Childhood acute lymphoblastic leukaemia; Children; Children & youth; Confidence intervals; Epidemiology; Etiology; Female; Hospitals; Humans; Infant; Infant, Newborn; Interviews; Leukemia; Mothers; Population studies; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology; Prenatal and postnatal conditions; Regression analysis; Risk analysis; Risk Factors; Sample size; Statistical analysis; São Paulo; Young Adult; Brazil; SES; ALL; PAC-DT/UNEB; Caesarean section; Case-control study; Childhood acute lymphoblastic leukaemia; DNV; SEADE Foundation; UNEB; USP; São Paulo; Prenatal and postnatal conditions; WHO
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2020.101851

•No statistically significant associations between caesarean section and ALL were observed.•Children born by caesarean section had a slight non-significant (NS) increased risk of ALL.•Children under 3 years old born by caesarean section had the highest risk of ALL (NS).•Children of mothers born by caesarean section in the highest educational group had a reduced risk of ALL (NS). Brazil has high rates of caesarean sections, which has been suggested as a risk factor for acute lymphoblastic leukaemia (ALL). In addition, some pre- and postnatal conditions have been identified as relevant in the etiology of ALL. Investigate the association of caesarean sections, pre- and postnatal conditions with childhood ALL in the State of São Paulo. Population-based case-control study including children that are below10 years old. Information on study variables was obtained through face to face interviews, through a questionnaire, and the State of São Paulo Declarations of Live Births database. The conditional and unconditional logistic regression approaches were used to calculate the odds ratio (OR) of the associations between caesarean sections, pre- and postnatal conditions with ALL, and 95 % confidence intervals (95 % CI). We observed a weak and non-statistically significant risk for ALL among children exposed to caesarean sections (unconditional logistic regression OR 1.08; 95 % CI 0.70–1.66; conditional logistic regression OR 1.21; 95 % CI 0.72–2.02), but among children under 3 years old and born through a caesarean sections, the risk of ALL was greater (unconditional logistic regression OR 1.70; 95 % CI 0.69–4.21). A negative association for ALL was observed among children with mothers who reported 12 years of schooling or more (unconditional logistic regression OR 0.34; 95 % CI 0.16−0.69). We found a tenuous suggestive association between caesarean sections and childhood ALL. The mother's high level of education showed an inverse association with ALL.