Abstract
Information on 16,193 infants delivered in Great Britain in one week of April, 1970 was collected by midwives at the birth and during the first 7 days of life. Using multiple sources, 33 children developing cancer by 1980 were identified from this cohort, giving an incidence of 2.04 per 1,000 total births by the age of 10. Comparisons of these 33 children were made with 99 controls, three for each index case, matched on maternal age, parity and social class. Statistically significant associations were initially found with maternal X-rays and smoking during pregnancy, and the use of analgesics such as pethidine during labour, confirming the findings of retrospective case-control studies. Unexpected statistically significant associations were found with delivery of the child outside term, and drug administration in the first week of life. The latter was found in the absence of an association with neonatal abnormalities in the child and relates mostly to the administration of prophylactic drugs such as vitamin K. Logistic regression involving the whole cohort showed independent statistical associations with maternal smoking (OR 2.5), and drugs to the infant (OR 2.6). After adjusting for these factors no other statistically significant associations were found.
Highlights
Inter-relationships We have shown above that five factors were statistically associated with childhood cancer: antenatal smoking of mother, antenatal X-rays, gestation outside 39-41 weeks, pethidine or Pethilorfan in labour and drugs administered to the neonate (Table V)
Most studies of the factors acting on fetal or early life that are relevant to childhood cancer have been, for obvious reasons, case-control in design (Gilman et al, 1988, 1989; Kneale & Stewart, 1976; McKinney et al, 1987); few prospective studies have been carried out
In the present prospective study, we find evidence of the well-known relationship between childhood cancer and diagnostic irradiation in utero (Stewart, 1958), as well as more recently reported associations with smoking in pregnancy (Stjernfeldt et al, 1986; Neutel & Buck, 1971) and with analgesics and sedatives taken during labour (Gilman et al, 1989), and with pethidine in particular (Gilman et al, 1989; McKinney et al, 1987)
Summary
Information on 16,193 infants delivered in Great Britain in one week of April 1970 was collected by midwives at the birth of the child and during the first 7 days of life (Chamberlain et al, 1975). These children were followed up at ages 5 and 10 by the Child Health and Education Study. In all 80% and 94% respectively were successfully contacted (Butler et al, 1982; Butler & Golding, 1986). Cases of cancer in the cohort were identified in three ways: from death certificates, through the Cancer Registration scheme, and at the follow-up interviews at the ages of 5 and 10. Factors: age of the mother at the birth of the child, parity and social class (based on the occupation of the mother's husband at the time of the birth), marital status at delivery, and whether the birth was single or multiple
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