Abstract 3441: Application of a maternal comorbidity index to predict childhood cancer risk: A population-based case-control study in Denmark
Authors: Adenekan Tobiloba Adanma , Heck Julia E. , Yin Cheng , Hansen Johnni 
Published: March 2024

Abstract
Background: Maternal health has been found to be an indicator of children’s health and has also been found to affect the risk of childhood diseases. Children are especially susceptible to in-utero exposures. A mother’s health conditions before and during pregnancy could have important consequences for her child's health, including cancer development, as was observed in some prior studies.
Objectives: This study aimed to identify the impact of varying maternal comorbidities on the development of childhood cancers. This study applied an Obstetric Comorbidity Index (Bateman et al, 2013) to examine maternal comorbid conditions in childhood cancer risk.
Methods: Using maternal and birth records, and cancer records from the Danish Cancer Registry, we conducted a population-based case-control study with two population groups- the first population included cases (n=2578) and controls (n=64450) with ICD-10 diagnoses from 1994-2013, and the second population included cases (n=8339) and controls (n=208475) with ICD-8 and 10 diagnoses from 1977-2013. Maternal comorbidities were ascertained from the National Patient Register using the Obstetric Comorbidity Index. We estimated the risk of childhood cancer using conditional logistic regression.
Results: Multiple gestation pregnancy (OR=1.17, 95% CI 1.05, 1.30), maternal pre-existing diabetes (OR=1.68, 95% CI 1.14, 2.48), congenital heart disease (OR=2.62, 95% CI 1.13, 6.09) and previous cesarean delivery (OR=1.35, 95% CI 1.03, 1.75) showed an increased risk of childhood cancers (all types combined). Children born to mothers between the ages of 35 and 39 also had a higher risk of cancer as compared to those born before. In the 1977-2013 population, there was an increased risk of acute lymphocytic leukemia (ALL; OR=1.08, 95% CI 1.04, 1.13) and rhabdomyosarcoma (OR=1.13, 95% CI 1.01, 1.27) for each unit of increase on the Obstetric Comorbidity Index. There was also an increased risk of retinoblastoma (OR=1.16, 95% CI 1.01, 1.32) for each unit of increase on the maternal comorbidities index in the 1994-2013 population. Examining mothers that had a score of one or more in the Obstetric Comorbidity Index, there was a higher risk of ALL (OR=1.43, 95% CI 1.26, 1.62), non-Hodgkin lymphoma (OR=1.50, 95% CI 1.17, 1.91), Burkitt lymphoma (OR=1.71, 95% CI 1.12, 2.61), and rhabdomyosarcoma (OR=1.58, 95% CI 1.10, 2.26) for children whose mothers with at least one maternal comorbidity. A similar trend was observed in the 1994-2013 population for ALL, non-Hodgkin lymphoma, and Burkitt lymphoma.
Conclusion: The results of the study show varying effects of exposure to one or more maternal comorbidities on individual pediatric cancer types, and an overall increased risk of most cancers development in children with exposure of mothers to 1 or more maternal comorbidities.
Citation Format: Tobiloba Adanma Adenekan, Julia E. Heck, Cheng Yin, Johnni Hansen. Application of a maternal comorbidity index to predict childhood cancer risk: A population-based case-control study in Denmark [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3441.