Prenatal exposure to medication and risk of childhood cancer – a systematic review and meta-analysis
Notice bibliographique
Résumé
BACKGROUND: The use of medication during pregnancy carries a potential health risk, including childhood cancer, for the unborn child. However, most drugs examined in previous observational studies have shown inconsistent results with the risk of childhood cancer, and these findings have not been consolidated in drug-specific meta-analyses. METHODS: We conducted a systematic search in the databases PubMed and Web of Science for studies on medication use during pregnancy and childhood cancer risk. Studies with exposure to diethylstilbestrol as a known teratogen were excluded. Meta-analyses were conducted if ≥ 3 studies on the same research question were available to calculate pooled estimates for random effects models with 95% confidence intervals (CI). The I2 statistic was calculated to quantify between-study heterogeneity. Statistical significance of I2 was analyzed using Q statistic (P value for heterogeneity (P)). Study quality was assessed with a scoring tool adapted from the Newcastle–Ottawa Scale and ROBINS-E/I. RESULTS: Of 2,366 identified studies, 80 were included in the systematic review. Of these, 68 studies with a total of 14,396,922 participants were included in meta-analyses, covering 13 medication types and 11 childhood cancer sites across 70 analyses. From 54 site-specific analyses, we observed four risk reductions and eleven increases in risk. We found an increased risk for prenatal exposure to any kind of antibiotics and acute lymphoblastic leukemia (ALL; estimate (ES) = 1.14 (95%CI 1.03; 1.25), I2 = 19.1%, P = 0.26). For specific antibiotics, nitrosatable antibiotics were associated with an increased risk of childhood cancer overall (ES = 1.32 (1.13; 1.55), I2 = 0.0%, P = 0.98). Maternal intake of vitamin and mineral supplements was associated with a reduced risk of acute leukemia (AL) (ES = 0.72 (0.54; 0.96), I2=46.3%, P = 0.16), ALL (ES = 0.81 (0.67; 0.99), I2 = 66.6%, P = 0.001) and tumors of the central nervous system (CNS; ES = 0.77 (0.62; 0.96), I2 = 67.2%, P = 0.002). DISCUSSION: Our results suggest that the use of antibiotics during pregnancy was associated with an increased childhood cancer risk, although this association is likely influenced by the underlying maternal infections that required treatment. This highlights the importance of considering maternal health factors when interpreting medication–related associations. Supplementation of vitamins and minerals during pregnancy might decrease the risk of AL, ALL and CNS tumors in children.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».