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01-10-2014 | Original paper

Maternal reproductive history, fertility treatments and folic acid supplementation in the risk of childhood acute leukemia: the ESTELLE Study

Authors: Roula Ajrouche, Jérémie Rudant, Laurent Orsi, Arnaud Petit, André Baruchel, Brigitte Nelken, Marlène Pasquet, Gérard Michel, Christophe Bergeron, Stéphane Ducassou, Virginie Gandemer, Patrick Lutz, Laure Saumet, Xavier Rialland, Denis Hémon, Jacqueline Clavel

Published in: Cancer Causes & Control | Issue 10/2014

Abstract

Purpose

To investigate the potential involvement of fertility treatments and other conditions of becoming pregnant (infertility, getting pregnant on birth control, maternal history of fetal loss) and folic acid supplements in the etiology of childhood leukemia (CL).

Methods

The ESTELLE study included 747 cases of CL [636 cases of acute lymphoblastic leukemia (ALL) and 100 of acute myeloblastic leukemia (AML)] diagnosed in France in 2010–2011 and 1,421 population controls frequency-matched with the cases on age and gender. Data were obtained from structured telephone questionnaires administered to mothers. The odds ratios (OR) and their 95 % confidence intervals were estimated using unconditional regression models adjusted for potential confounders.

Results

CL was not associated with difficulty in becoming pregnant [OR 0.9 (0.7–1.2)], in vitro fertilisation [OR 0.6 (0.3–1.5)] or the use of any fertility treatment [OR 0.8 (0.5–1.1)] for the index pregnancy. CL was not significantly associated with becoming pregnant on contraception [OR 1.2 (0.8–1.8)], but a positive association was observed for third generation oral contraception [OR 4.3 (1.2–16.2)]; however, the result is based on small numbers. Folic acid supplementation during pregnancy was not associated with CL, but an inverse borderline association was observed for supplementation initiated in the 3 months preceding pregnancy [OR 0.7 (0.5–1.0)]. In addition, maternal histories of stillbirth and miscarriage were associated with ALL [OR 2.6 (1.1–5.9)] and AML [OR 1.8 (1.1–2.8)], respectively.

Conclusions

The findings do not suggest that infertility and fertility treatments are risk factors for CL. They suggest that maternal histories of stillbirth and miscarriage may be more frequent among mothers of CL cases and that folic acid supplementation during preconception may reduce the risk of CL.

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Title: Maternal reproductive history, fertility treatments and folic acid supplementation in the risk of childhood acute leukemia: the ESTELLE Study
Authors: Roula Ajrouche
Jérémie Rudant
Laurent Orsi
Arnaud Petit
André Baruchel
Brigitte Nelken
Marlène Pasquet
Gérard Michel
Christophe Bergeron
Stéphane Ducassou
Virginie Gandemer
Patrick Lutz
Laure Saumet
Xavier Rialland
Denis Hémon
Jacqueline Clavel
Publication date: 01-10-2014
Publisher: Springer International Publishing
Published in: Cancer Causes & Control / Issue 10/2014
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-014-0429-8

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