Maternal Supplementation with Folic Acid and Other Vitamins and Risk of Leukemia in Offspring A Childhood Leukemia International Consortium Study

作者：Metayer Catherine^*; Milne Elizabeth; Dockerty John D; Clavel Jacqueline; Pombo de Oliveira Maria S; Wesseling Catharina; Spector Logan G; Schuez Joachim; Petridou Eleni; Ezzat Sameera; Armstrong Bruce K; Rudant Jeremie; Koifman Sergio; Kaatsch Peter; Moschovi Maria; Rashed Wafaa M; Selvin Steve; McCauley Kathryn; Hung Rayjean J; Kang Alice Y; Infante Rivard Claire

来源：Epidemiology, 2014, 25(6): 811-822.

DOI：10.1097/EDE.0000000000000141

Background: Maternal prenatal supplementation with folic acid and other vitamins has been inconsistently associated with a reduced risk of childhood acute lymphoblastic leukemia (AL). Little is known regarding the association with acute myeloid leukemia (AML), a rarer subtype. %26lt;br%26gt;Methods: We obtained original data on prenatal use of folic acid and vitamins from 12 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980-2012), including 6,963 cases of AL, 585 cases of AML, and 11,635 controls. Logistic regression was used to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for child%26apos;s age, sex, ethnicity, parental education, and study center. %26lt;br%26gt;Results: Maternal supplements taken any time before conception or during pregnancy were associated with a reduced risk of childhood AL; odds ratios were 0.85 (95% CI = 0.78-0.92) for vitamin use and 0.80 (0.71-0.89) for folic acid use. The reduced risk was more pronounced in children whose parents%26apos; education was below the highest category. The analyses for AML led to somewhat unstable estimates; ORs were 0.92 (0.75-1.14) and 0.68 (0.48-0.96) for prenatal vitamins and folic acid, respectively. There was no strong evidence that risks of either types of leukemia varied by period of supplementation (preconception, pregnancy, or trimester). %26lt;br%26gt;Conclusions: Our results, based on the largest number of childhood leukemia cases to date, suggest that maternal prenatal use of vitamins and folic acid reduces the risk of both AL and AML and that the observed association with AL varied by parental education, a surrogate for lifestyle and sociodemographic characteristics.

• 出版日期2014-11
• 单位河北医科大学; McGill