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Fertility treatments, congenital malformations, fetal loss, and childhood acute leukemia: The ESCALE study (SFCE)
Author(s) -
Rudant Jérémie,
Amigou Alicia,
Orsi Laurent,
Althaus Thomas,
Leverger Guy,
Baruchel André,
Bertrand Yves,
Nelken Brigitte,
Plat Geneviève,
Michel Gérard,
Sirvent Nicolas,
Chastagner Pascal,
Ducassou Stéphane,
Rialland Xavier,
Hémon Denis,
Clavel Jacqueline
Publication year - 2013
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24192
Subject(s) - medicine , fertility , odds ratio , pregnancy , abortion , confidence interval , pediatrics , obstetrics , population , acute myeloblastic leukemia , gynecology , leukemia , environmental health , biology , genetics
Background This study investigated the relationships between childhood acute leukemia (AL) and selective maternal and birth characteristics, including congenital malformations and the use of fertility treatment, for which the literature remains scarce. Procedure The national registry‐based case–control study ESCALE was carried out in France in 2003–2004. Population controls were frequency matched with cases on age and gender. Data were obtained from structured telephone questionnaires. Odds ratios (OR) and their 95% confidence intervals were estimated using unconditional regression models adjusted for potential confounders. Results In all, 764 cases of AL (648 lymphoblastic AL (acute lymphoblastic leukemia, ALL) and 101 myeloblastic AL) and 1,681 controls were included. The AL cases' mothers reported congenital malformations more frequently than the controls' mothers (OR = 1.5 [1.0–2.4]). ALL was significantly associated with the use of fertility treatment for the index pregnancy (OR = 1.9 [1.3–2.8]). In particular, ALL was associated with ovulation induction only (OR = 2.6 [1.6–4.3]), but not with in vitro fertilization (IVF, OR = 1.0 [0.4–2.3]) or artificial insemination (OR = 1.3 [0.5–3.9]). A positive association was also observed for the difficulty of becoming pregnant without fertility treatment (OR = 1.5 [1.0–2.1]). AL was positively associated with a history of voluntary abortion (OR = 1.4 [1.1–1.8]) but not with a history of spontaneous (OR = 0.8 [0.7–1.0]) or therapeutic (OR = 0.7 [0.5–1.1]) abortion. Conclusion The results suggest that subfertility in itself and ovulation induction may be associated with ALL, and support a positive association with congenital malformations. The links with the various types of fertility drugs and the underlying causes of infertility need to be investigated further. Pediatr Blood Cancer 2013;60:301–308. © 2012 Wiley Periodicals, Inc.