649: The risk for childhood malignancies in offspring of obese mothers: A population-based cohort study

Abstract

Fetal origins of adult disease are of major interest. Potential long-term effects of the intrauterine environment on offspring's health have long been studied. We aimed to evaluate the effect of maternal obesity on the long-term risk for childhood malignancies in the offspring. A population based cohort analysis was performed comparing the risk for long-term childhood malignancies (up to the age of 18 years) in children born to mothers with and without pre-gestational obesity (defined as maternal pre-pregnancy body mass index of 30 kg/m2 or more). Childhood malignancies were pre-defined based on ICD-9 codes, as recorded in the hospital medical files. Deliveries occurred between the years 1991-2014 in a tertiary medical center. Newborns with congenital malformations and children with benign tumors were excluded from the long term analyses. A Kaplan-Meier survival curve was constructed to compare cumulative oncological morbidity in both groups over time and a Cox proportional hazards model was used to control for confounders. During the study period 241,273 newborns met the inclusion criteria; 3268 of which were born to obese mothers. Offspring to obese mothers presented a significantly higher risk of several childhood (head and neck, vulva or vagina, ophthalmic, adrenal and brain; Table) as well as an increased risk for total childhood malignancies (OR=2.1, 95% CI 1.2-3.7; p=0.010). The cumulative incidences of total oncological morbidity, using a Kaplan-Meier survival curve, was significantly higher in offspring of obese mothers (Log rank test p=0.023; Figure). In the Cox regression model, while controlling for maternal age, maternal diabetes, preterm delivery and hypertensive disorders, pre-pregnancy obesity remained an independent risk factor for childhood malignancies in the offsprings (adjusted HR 1.9, 95% CI 1.1-3.4, p=0.028). Maternal obesity may create an intrauterine environment that leads to an increased risk for childhood malignancies in the offspring’s.View Large Image Figure ViewerDownload Hi-res image Download (PPT)