Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 96-104 (doi:10.1542/peds.2008-3069)
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ARTICLE

Cancer Risk Among Children With Very Low Birth Weights

Logan G. Spector, PhDa,b, Susan E. Puumala, MSa, Susan E. Carozza, PhDc, Eric J. Chow, MD, MPHd, Erin E. Fox, PhDe, Scott Horel, MSc, Kimberly J. Johnson, PhDa, Colleen C. McLaughlin, PhDf, Peggy Reynolds, PhDg, Julie Von Behren, MPHg and Beth A. Mueller, DrPHd

a Division of Epidemiology/Clinical Research, Department of Pediatrics
b Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
c Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A & M Health Sciences Center, College Station, Texas
d Department of Pediatric Hematology-Oncology, Fred Hutchinson Cancer Research Center, Seattle, Washington
e Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
f New York State Cancer Registry, New York Department of Health, Albany, New York
g Northern California Cancer Center, Union City, California

OBJECTIVE: The risk of hepatoblastoma is strongly increased among children with very low birth weight (<1500 g). Because data on very low birth weight and other childhood cancers are sparse, we examined the risk of malignancy with very low birth weight in a large data set.

METHODS: We combined case-control data sets created by linking the cancer and birth registries of California, Minnesota, New York, Texas, and Washington states, which included 17672 children diagnosed as having cancer at 0 to 14 years of age and 57966 randomly selected control subjects. Unconditional logistic regression analysis was used to examine the association of cancer with very low birth weight and moderately low birth weight (1500–1999 g and 2000–2499 g, respectively), compared with moderate/high birth weight (≥2500 g), with adjustment for gender, gestational age, birth order, plurality, maternal age, maternal race, state, and year of birth.

RESULTS: Most childhood cancers were not associated with low birth weights. However, retinoblastomas and gliomas other than astrocytomas and ependymomas were possibly associated with very low birth weight. The risk of other gliomas was also increased among children weighing 1500 to 1999 g at birth.

CONCLUSIONS: These data suggested no association between most cancers and very low birth weight, with the exception of the known association of hepatoblastoma and possibly moderately increased risks of other gliomas and retinoblastoma, which may warrant confirmation.

Key Words: infant • very low birth weight • cancer • case-control studies • registries

Abbreviations: CI—confidence interval • OR—odds ratio • VLBW—very low birth weight

Accepted Jan 7, 2009.


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