Mode of Delivery, Birth Characteristics and Early-Onset Non-Hodgkin Lymphoma in a Population-Based Case-Control Study
Menée aux Etats-Unis auprès de 153 200 témoins et de 3 604 patients atteints d'un lymphome non hodgkinien diagnostiqué avant l'âge de 37 ans, cette étude analyse l'association entre le mode d'accouchement, des caractéristiques de naissance et le risque de développer la maladie
Background: The etiology of non-Hodgkin lymphoma (NHL) in children, adolescents, and young adults (AYA) is not well-understood. Methods: We evaluated potential associations between mode of delivery, birth characteristics and NHL risk in a population-based case-control study, which included 3,064 cases of NHL (490 with Burkitt lymphoma, 981 with diffuse large B-cell lymphoma [DLBCL], and 978 with T-cell NHL) diagnosed at the age of 0-37 years in California during 1988-2015 and 153,200 controls frequency-matched on year of birth. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from an unconditional multivariable logistic regression model that included year of birth and birth characteristics. Results: Individuals born via cesarean section had a decreased risk of pediatric Burkitt lymphoma (age 0-14 years; OR=0.71, 95% CI: 0.51-0.99) and pediatric T-cell NHL (OR=0.73, 95% CI: 0.55-0.97) compared to those born vaginally. Having a birth order of 2nd (OR=0.73, 95% CI: 0.57-0.93) or 3rd or higher (OR=0.76, 95% CI: 0.58-0.99) was associated with a lower risk of pediatric T-cell NHL compared to first-borns. AYA (age 15-37 years) with a heavier birthweight had an elevated risk of DLBCL (OR for each kg = 1.16, 95% CI: 1.00-1.35). Associations between other birth characteristics including plurality, maternal age, maternal education, and NHL risk also exhibited variations across subgroups based on age of diagnosis and histologic subtype. Conclusions: These findings support a role of mode of delivery and birth characteristics in the etiology of early-onset NHL. Impact: This study underscores the etiological heterogeneity of early-onset NHL.