Maternal urinary and genital tract infections during pregnancy tied to childhood leukaemia in offspring: JAMA

Maternal infection may cause chromosomal alterations in the fetus, increasing the risk of childhood leukaemia. A recent analysis shows an association between maternal influenza, rubella, and varicella during pregnancy and a higher risk of childhood leukaemia.

Maternal infection during pregnancy potentially causes fetal genetic and immunological abnormalities. This has been associated with childhood leukaemia in small cohort studies.

The question is, “In Denmark, Is there any risk association between maternal infection during pregnancy and risk of childhood leukaemia among offspring?”

Considering this background, researchers investigated the question above in 2 million Danish children. The primary outcome was acute lymphoid leukaemia (ALL) and acute myeloid leukaemia (AML).

The conclusive study points are:

• The study had 2 222 797 children, with 51.3% boys.
• One thousand three hundred seven children were diagnosed with leukaemia with 1050 cases of ALL, 165 cases of AML and 92 other cases during 27 million person-years of follow-up (mean 12.0 years per person).
• There was a 35 % increased risk of leukaemia in children born to mothers with infection during pregnancy, with a hazard ratio of 1.35 compared to mothers who had no history of maternal infection during pregnancy.
• Maternal genital and urinary tract infections were tied to 142% and 65% increased risk of childhood leukaemia, with HRs of 2.42 and 1.65, respectively.
• There was no association with respiratory tract, digestive, brain tumours, lymphoma, or other childhood cancers.

The author He et al. said, “There is a scarcity of data regarding the aetiology of childhood leukaemia, and findings of our study using data from 7 Danish national registries provides a crucial direction regarding childhood leukaemia etiology and also are directive in establishing preventive measures.”

They said, “Certain maternal infections during pregnancy can increase the risk of childhood leukaemia in offspring.”

As acknowledged, the study was funded by the National Natural Science Foundation of China.

REFERENCES

He J, Yu Y, Fang F, et al. Evaluation of Maternal Infection During Pregnancy and Childhood Leukemia Among Offspring in Denmark. JAMA Netw Open. 2023;6(2):e230133. doi:10.1001/jamanetworkopen.2023.0133