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Abstract：
The role of environmental and behavioral exposures on childhood leukemia etiology is poorly understood. We examined the association of maternal and paternal tobacco smoking at different time points with the risk of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) in Costa Rican children.
We conducted a population-based case-control study on childhood leukemia in Costa Rica. Cases (n ALL = 252; n AML = 40) were diagnosed between 1995 and 2000 (aged <15 years at diagnosis) and identified from the Costa Rican Cancer Registry and the National Children\'s Hospital. A total of 578 frequency-matched population controls were sampled from the National Birth Registry. Parental tobacco smoking was assessed via face-to-face interviews. We used logistic regression models to examine the association of paternal and maternal tobacco smoking before conception, during pregnancy, and after birth with childhood ALL and AML risk, adjusted for child sex, birth year, maternal/paternal age, and parental education.
Paternal smoking before conception, during pregnancy, and after birth was associated with an increased risk of childhood AML (Odds Ratio (OR): 2.51, 95% CI: 1.21-5.17; OR: 3.21, 95% CI: 1.56-6.60; and OR: 2.83, 95% CI: 1.36-5.90, respectively). Maternal smoking during pregnancy was also associated with a modest, but imprecise increase in AML risk. We observed null associations of maternal and paternal smoking with ALL in the offspring.
Our results suggest an association between parental smoking and risk of AML, but not ALL, in Costa Rican children. These findings add to the established evidence of numerous health risks associated with smoking and highlight the potential harm of smoking during sensitive windows of the development of fetus and child.
We conducted a population-based case-control study on childhood leukemia in Costa Rica. Cases (n ALL = 252; n AML = 40) were diagnosed between 1995 and 2000 (aged <15 years at diagnosis) and identified from the Costa Rican Cancer Registry and the National Children\'s Hospital. A total of 578 frequency-matched population controls were sampled from the National Birth Registry. Parental tobacco smoking was assessed via face-to-face interviews. We used logistic regression models to examine the association of paternal and maternal tobacco smoking before conception, during pregnancy, and after birth with childhood ALL and AML risk, adjusted for child sex, birth year, maternal/paternal age, and parental education.
Paternal smoking before conception, during pregnancy, and after birth was associated with an increased risk of childhood AML (Odds Ratio (OR): 2.51, 95% CI: 1.21-5.17; OR: 3.21, 95% CI: 1.56-6.60; and OR: 2.83, 95% CI: 1.36-5.90, respectively). Maternal smoking during pregnancy was also associated with a modest, but imprecise increase in AML risk. We observed null associations of maternal and paternal smoking with ALL in the offspring.
Our results suggest an association between parental smoking and risk of AML, but not ALL, in Costa Rican children. These findings add to the established evidence of numerous health risks associated with smoking and highlight the potential harm of smoking during sensitive windows of the development of fetus and child.
摘要：
环境和行为暴露对儿童白血病病因的作用知之甚少。我们研究了哥斯达黎加儿童在不同时间点的母亲和父亲吸烟与急性淋巴细胞白血病（ALL）和急性髓细胞性白血病（AML）风险的关系。
我们对哥斯达黎加儿童白血病进行了一项基于人群的病例对照研究。病例（nALL=252；nAML=40）在1995年至2000年之间诊断（诊断时年龄<15岁），并从哥斯达黎加癌症登记处和国家儿童医院确定。从国家出生登记处共采样了578个频率匹配的人口对照。父母吸烟是通过面对面访谈评估的。我们使用逻辑回归模型来检查受孕前父亲和母亲吸烟的关系，怀孕期间,出生后有儿童ALL和AML风险，适应儿童性，出生年份,母亲/父亲年龄，和父母教育。
怀孕前父亲吸烟，怀孕期间,出生后与儿童AML的风险增加相关(赔率比(OR):2.51,95%CI:1.21-5.17;OR:3.21,95%CI:1.56-6.60;OR:2.83,95%CI:1.36-5.90).孕妇在怀孕期间吸烟也与适度，但AML风险的增加不精确。我们观察到后代中母亲和父亲吸烟与ALL的关联为零。
我们的研究结果表明父母吸烟与AML风险之间存在关联，但不是全部，哥斯达黎加的孩子。这些发现增加了与吸烟相关的许多健康风险的既定证据，并强调了在胎儿和儿童发育的敏感窗口期间吸烟的潜在危害。
我们对哥斯达黎加儿童白血病进行了一项基于人群的病例对照研究。病例（nALL=252；nAML=40）在1995年至2000年之间诊断（诊断时年龄<15岁），并从哥斯达黎加癌症登记处和国家儿童医院确定。从国家出生登记处共采样了578个频率匹配的人口对照。父母吸烟是通过面对面访谈评估的。我们使用逻辑回归模型来检查受孕前父亲和母亲吸烟的关系，怀孕期间,出生后有儿童ALL和AML风险，适应儿童性，出生年份,母亲/父亲年龄，和父母教育。
怀孕前父亲吸烟，怀孕期间,出生后与儿童AML的风险增加相关(赔率比(OR):2.51,95%CI:1.21-5.17;OR:3.21,95%CI:1.56-6.60;OR:2.83,95%CI:1.36-5.90).孕妇在怀孕期间吸烟也与适度，但AML风险的增加不精确。我们观察到后代中母亲和父亲吸烟与ALL的关联为零。
我们的研究结果表明父母吸烟与AML风险之间存在关联，但不是全部，哥斯达黎加的孩子。这些发现增加了与吸烟相关的许多健康风险的既定证据，并强调了在胎儿和儿童发育的敏感窗口期间吸烟的潜在危害。
