title: Birth size in the most recent pregnancy and maternal mortality in premenopausal breast cancer by tumor characteristics.
abstract: The main aim of this study was to investigate possible associations between measures of offspring size at birth in the most recent pregnancy before premenopausal breast cancer diagnosis and the risks of maternal breast cancer mortality, taking tumor characteristics into account. We also aimed to investigate if these associations are modified by age at childbirth, time since childbirth, parity, and age at diagnosis. We followed 6,019 women from their date of premenopausal breast cancer (diagnosed from 1992 to 2008) until emigration, death or December 31st, 2009, whichever occurred first. We used Cox proportional hazard regression models, adjusted for parity, age at diagnosis, and education level, to estimate associations between women pregnancy, cancer characteristics and offspring birth characteristics, and mothers' mortality risk. In stratified analyses, mortality risks were estimated by tumor stage, ER or PR status. There was no association between offspring birth weight (HR = 1.00, 95 % CI 0.99-1.01, when used as a continuous variable), birth weight for gestational age or ponderal index, and premenopausal breast cancer mortality. Similarly, in analyses stratified by tumor stage, receptor status, and time difference between last pregnancy and date of diagnosis, we found no associations between birth size and breast cancer mortality. Our findings suggest that the hypothesis that "premenopausal breast cancer mortality is associated with offspring birth characteristics in the most recent pregnancy before the diagnosis" may not be valid. In addition, these associations are not modified by tumor characteristics.
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, 171 76, Stockholm, Sweden, mohammadhossein.hajiebrahimi@ki.se.
authors.forename: Mohammadhossein
authors.initials: M
authors.lastname: Hajiebrahimi
authors.forename: Sven
authors.initials: S
authors.lastname: Cnattingius
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.forename: Chung-Cheng
authors.initials: CC
authors.lastname: Hsieh
authors.forename: Johan
authors.initials: J
authors.lastname: Ahlgren
authors.forename: Jan
authors.initials: J
authors.lastname: Adolfsson
authors.forename: Shahram
authors.initials: S
authors.lastname: Bahmanyar
mesh_terms: D000328:Adult; D001724:Birth Weight; D001943:Breast Neoplasms / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D017697:Premenopause; D016016:Proportional Hazards Models; D013548:Sweden