Childhood solid tumours in relation to infections in the community in Cumbria during pregnancy and around the time of birth

Abstract

In a retrospective cohort study of all 99 976 live births in Cumbria, 1975-1992, we investigated whether higher levels of community infections during the mother's pregnancy and in early life were risk factors for solid tumours (brain/spinal and other tumours), diagnosed 1975-1993 under age 15 years. Logistic regression was used to relate risk to incidence of community infections in three prenatal and two postnatal quarters. There was an increased risk of brain/spinal tumours among children exposed around or soon after birth to higher levels of community infections, in particular measles (OR for trend=2.1, 95%CI : 1.3-3.6, P=0.008) and influenza (OR for exposure=3.3, 95%CI : 1.5-7.4, P=0.005). There was some evidence of an association between exposure to infections around and soon after birth and risk of other tumours, but this may have been a chance finding. The findings are consistent with other recent epidemiological studies suggesting brain tumours may be associated with perinatal exposure to infections.

Figure 1

Pre- and post-natal exposure periods considered

Figure 2

Annual incidence of community infections (number of cases/inter-censal estimate of population), for all of Cumbria, during 1975–92. (The World Health Organisation rule for coding underlying cause of death changed in 1984 (- - - - - -) (Rooney and Devis, 1996); therefore analyses involving deaths from respiratory infections and influenza were stratified by time period: 1975–83 and 1984–92.)