title: Pregnancy, maternal exposure to analgesic medicines, and leukemia in Brazilian children below 2 years of age.
abstract: Childhood leukemia etiology, and mainly the interactions of genetic and environmental risk factors, remains largely unexplored. This national hospital-based case-control study was carried out in Brazil among children aged 0-23 months who were recruited at cancer and general hospitals in 13 states. Maternal medicine intake during pregnancy, including analgesic intake, was assessed by face-to-face interviews with the mothers of 231 leukemia patients and 411 controls. Unconditional logistic regression was used to ascertain crude and adjusted odds ratios (ORs), and their 95% confidence intervals (CIs) for the association between maternal analgesic use during pregnancy and early age leukemia. Acetaminophen use during the first trimester of pregnancy showed an OR=0.39 (95% CI 0.17-0.93) for acute lymphocytic leukemia and an OR=0.37 (95% CI 0.16-0.88) for use in the second trimester. For acute myeloid leukemia, an OR=0.11 (95% CI 0.02-0.97) was found following acetaminophen use in the second trimester. For acute lymphocytic leukemia, the exclusive use of dipyrone during preconception showed an OR=1.63 (95% CI 1.06-2.53) and dipyrone intake during lactation showed an OR=2.00 (95% CI 1.18-3.39). These results suggest that acetaminophen use during pregnancy may protect against development of early age leukemia in the offspring, whereas dipyrone use may act as a risk factor for such an outcome.
authors.affiliation: aNational School of Public Health/FIOCRUZ bPediatric Hematology-Oncology Program/INCA, Rio de Janeiro, Brazil.
authors.forename: Arnaldo C
authors.initials: AC
authors.lastname: Couto
authors.forename: Jeniffer D
authors.initials: JD
authors.lastname: Ferreira
authors.forename: Maria S
authors.initials: MS
authors.lastname: Pombo-de-Oliveira
authors.forename: Sérgio
authors.initials: S
authors.lastname: Koifman
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D018811:Maternal Exposure; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000700:Analgesics