title: Parental alcohol consumption and risk of leukemia in the offspring: a systematic review and meta-analysis.
abstract: Parental alcohol consumption before and during pregnancy has been linked to adverse outcomes in the offspring including leukemogenesis. We, therefore, aimed to systematically assess and quantitatively synthesize published data on the association of paternal consumption during preconception and maternal consumption during pregnancy with leukemia risk in childhood (0-14 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed (until February 2016) and the reference lists of the relevant studies. Observational studies examining the association between parental alcohol consumption and childhood leukemia were considered eligible. Data extracted from 39 case-control studies (over 16 000 leukemia cases and 30 000 controls) were pooled and summary-effect estimates were calculated. Subgroup analyses were carried out by main acute leukemia type [lymphoblastic or myeloid), cytogenetics/genetic polymorphisms, and specific alcohol beverages. We found a statistically significant dose-response association of any level of maternal alcohol consumption compared with nondrinking during pregnancy exclusively with acute myeloid leukemia (AML) [odds ratio (OR)moderate consumption: 1.64, 95% confidence intervals (CIs): 1.23-2.17 and ORhigh consumption: 2.36, 95% CI: 1.60-3.49]. In contrast, no association of paternal preconception consumption with any leukemia type was noted. In beverage-specific analyses, only a positive association of maternal wine drinking with childhood AML was found, which was more pronounced in analyses including only studies on infant leukemia (ORwine: 2.12, 95% CI: 1.16-3.90). The largest ever meta-analysis shows a sizeable, statistically significant dose-response association of maternal alcohol consumption during index pregnancy with AML risk. Future research exploring the role of genetic polymorphisms is anticipated to shed light on the underlying pathophysiology.
authors.affiliation: aDepartment of Hygiene, Epidemiology and Medical Statistics bFirst Department of Obstetrics and Gynecology, School of Medicine, University of Athens cHaematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, 'Aghia Sophia' Children's Hospital dDepartment of Pediatric Hematology-Oncology, 'Pan. & Agl. Kyriakou' Children's Hospital eDepartment of Pediatric Haematology-Oncology, 'Aghia Sophia' Children's Hospital, Athens f2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital gDepartment of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki hDepartment of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Greece iProgram Medical Neurosciences, Charité-Medicine University, Berlin, Germany jCentral American Institute for Studies on Toxic Substances, National University, Heredia, Costa Rica kFaculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil lDepartment of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montre[Combining Acute Accent]al, Que[Combining Acute Accent]bec, Canada.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Karalexi
authors.forename: Nick
authors.initials: N
authors.lastname: Dessypris
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Thomopoulos
authors.forename: Evangelos
authors.initials: E
authors.lastname: Ntouvelis
authors.forename: Maria
authors.initials: M
authors.lastname: Kantzanou
authors.forename: Andreas-Antonios
authors.initials: AA
authors.lastname: Diamantaras
authors.forename: Maria
authors.initials: M
authors.lastname: Moschovi
authors.forename: Margarita
authors.initials: M
authors.lastname: Baka
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Hatzipantelis
authors.forename: Maria
authors.initials: M
authors.lastname: Kourti
authors.forename: Sophia
authors.initials: S
authors.lastname: Polychronopoulou
authors.forename: Eftichia
authors.initials: E
authors.lastname: Stiakaki
authors.forename: Ana-M
authors.initials: AM
authors.lastname: Mora
authors.forename: Victor
authors.initials: V
authors.lastname: Wunsch-Filho
authors.forename: Claire
authors.initials: C
authors.lastname: Infante-Rivard
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Loutradis
authors.forename: Eleni Th
authors.initials: ET
authors.lastname: Petridou
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D000434:Alcoholic Beverages / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced / Q000453:epidemiology* / Q000235:genetics; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D016017:Odds Ratio; D018812:Paternal Exposure / Q000009:adverse effects*; D011110:Polymorphism, Genetic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000139:chemically induced / Q000453:epidemiology* / Q000235:genetics; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors