title: Birth weight and other risk factors for acute leukemia in the Jerusalem Perinatal Study cohort.
abstract: OBJECTIVE
  To assess the effect of birth weight of children and their siblings and other perinatal/parental factors on the risk of acute leukemia.
  
  
  METHODS
  We linked data from the Jerusalem Perinatal Study, a population-based research cohort (n = 88,829) of offspring born 1964 to 1976, with Israel's Cancer Registry. Risk factors for acute leukemia were assessed using univariate and multivariate proportional hazards models.
  
  
  RESULTS
  Leukemias developed in 65 individuals [24 acute myeloid leukemias (AML) and 41 acute lymphoblastic leukemias (ALL)]. A positive linear relation was found between gender-adjusted birth weight and all leukemias [hazard ratio (HR) 1.85, 95% confidence interval (95% CI) 1.1-3.0] and AML (HR 2.9, 95% CI 1.3-6.4). The association between birth weight and AML was especially notable among infants (HR 8.14, 95% CI 1.8-38.9 for age 0 to 1 year) but was also observed among subjects ages >14 years at diagnosis. The relation was particularly strong among females (P = 0.001). Other risk factors for AML risk on univariate analysis were maternal origin, socioeconomic status, birth weight of sibling > 3,500 g, and family size. On multivariate analysis, only birth weight retained borderline significance (adjusted HR 2.38 per kg, 95% CI 1.0-5.7). Significant predictors for ALL in both univariate and multivariate analyses were male sex (adjusted HR 1.92, 95% CI 1.0-3.7) and birth weight categories > or = 3,000 g introduced into the model as nonlinear terms.
  
  
  CONCLUSIONS
  Birth weight is associated with an increased risk of acute leukemia in infants, children, and young adults. Perinatal factors play a role in the development of childhood leukemias, but the patterns of association vary by leukemia type.
authors.affiliation: Braun School of Public Health and Community Medicine, and Department of Hematology, Hadassah-Hebrew University, Jerusalem, Israel. ora@vms.huji.ac.il
authors.forename: Ora
authors.initials: O
authors.lastname: Paltiel
authors.forename: Susan
authors.initials: S
authors.lastname: Harlap
authors.forename: Lisa
authors.initials: L
authors.lastname: Deutsch
authors.forename: Ariella
authors.initials: A
authors.lastname: Knaanie
authors.forename: Sausan
authors.initials: S
authors.lastname: Massalha
authors.forename: Efrat
authors.initials: E
authors.lastname: Tiram
authors.forename: Micha
authors.initials: M
authors.lastname: Barchana
authors.forename: Yehiel
authors.initials: Y
authors.lastname: Friedlander
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001724:Birth Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D007951:Leukemia, Myeloid / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008498:Medical Record Linkage; D018743:Perinatal Care; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors