Abstract 847: Birth characteristics associated with childhood neuroblastoma incidence in Texas, 1995-2011
Authors: Lancon Kelsey B. , Schraw Jeremy M. , Foster Jennifer H. , Lupo Philip J. 
Published: July 2021

Abstract
Neuroblastoma (NB) is the most common extra-cranial solid tumor in infants and children, but there are few well-established risk factors. We investigated the associations of parental and infant characteristics with risk of neuroblastoma. Data on Texas children born 1995-2011 (N=637) and diagnosed with NB (any stage) was obtained from the Texas Cancer Registry and linked to birth certificates. From birth certificates we obtained data on parental (age, education, race/ethnicity) and child demographics (sex, gestational age at birth, mode of delivery) and selected maternal exposures (pre-pregnancy body mass index, alcohol/tobacco consumption, use of infertility treatment, parity, plurality). Birth certificate controls matched on sex and birth year were randomly selected from among children born during the same period, at a ratio of 10 controls per case. Unconditional logistic regression was used to estimate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between parental and infant characteristics and NB. Maternal race/ethnicity, maternal age, gestational age at delivery, and infant sex were associated with NB. Females were less likely to be diagnosed with NB as compared to males (aOR: 0.68; 95% CI: 0.57 - 0.81). Maternal age 35-39 years was associated with increased risk of NB as compared to maternal age 25-29 years (aOR: 1.41; 95% CI: 1.04 - 1.90) and there was a non-significantly elevated point estimate among women 40 years of age or older (aOR 1.62, 95% CI 0.88 - 2.82). Infants born to non-Hispanic Black or Hispanic mothers were less likely to develop NB as compared to infants born to non-Hispanic White mothers (aOR: 0.52; 95% CI: 0.38 - 0.70; aOR: 0.53; 95% CI 0.43 - 0.65, respectively). When compared to term infants (≥37 weeks gestational age), pre-term infants were at an increased risk of developing NB (aOR: 1.38; 95% CI 1.08 - 1.74). Further stratified, late pre-term infants (34 - &lt;37 weeks) were at an increased risk of developing NB as compared to term infants (aOR: 1.45; 95% CI 1.09 - 1.90), however there was no association between early pre-term delivery (&lt;34 weeks) and NB. Associations with pre-term birth were attenuated when infant cases were excluded, suggesting that the association may be driven by early delivery of infants diagnosed prenatally. The unadjusted OR of NB was increased for children born to mothers who reported the use of infertility treatment (OR: 4.05 , 95% CI 1.10 -12.21 ), although the small number of exposed cases precluded the estimation of adjusted odds ratios. No associations were observed for birth order, plurality, mode of delivery, maternal alcohol or tobacco use, maternal pre-pregnancy body mass index, or paternal age. In this population-based assessment, we confirmed associations between NB and maternal age, maternal race/ethnicity, and infant sex. We found evidence that use of infertility treatment may be associated with NB incidence.
Citation Format: Kelsey B. Lancon, Jeremy M. Schraw, Jennifer H. Foster, Philip J. Lupo. Birth characteristics associated with childhood neuroblastoma incidence in Texas, 1995-2011 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 847.