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Epidemiology

Maternal and childhood medical history and the risk of childhood brain tumours: a case–control study in Ontario, Canada

British Journal of Cancer volume 129, pages 318–324 (2023)Cite this article

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A Correction to this article was published on 13 September 2023

This article has been updated

Abstract

Background

Studies to date have yielded inconclusive results as to whether maternal medical history during pregnancy, and a child’s early-life medical history contribute to the development of childhood brain tumours (CBTs). This study examined associations between maternal and childhood medical history and the risk of CBTs.

Methods

The Childhood Brain Tumour Epidemiology Study of Ontario (CBREO) examined children 0–15 years of age with newly diagnosed CBTs from 1997 to 2003. Multivariable logistic regression analysis determined associations for prenatal medications and childhood medical history, adjusted for child’s demographics, and maternal education. Analyses were stratified by histology. A latency period analysis was conducted using 12- and 24-month lead times.

Results

Maternal intake of immunosuppressants during the prenatal period was significantly associated with glial tumours (OR 2.73, 95% CI 1.17–6.39). Childhood intake of anti-epileptics was significantly associated with CBTs overall, after accounting for 12-month (OR 8.51, 95% CI 3.35–21.63) and 24-month (OR 6.04, 95% CI 2.06–17.70) lead time before diagnosis. No associations for other medications were found.

Conclusions

This study underscores the need to examine potential carcinogenic effects of the medication classes highlighted and of the indication of medication use. Despite possible reverse causality, increased CBT surveillance for children with epilepsy might be warranted.

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Fig. 1: Odds ratios and 95% confidence intervals for the associations between maternal medication use during pregnancy and histology* of childhood brain tumours.
Fig. 2: Childhood anti-epilepsy medications and childhood brain tumour.

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Data availability

Data are available on request due to privacy/ethical restrictions.

Code availability

All statistical analyses were completed using STATA version 15.0. The code is available upon request from the corresponding author.

Change history

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Acknowledgements

This study was supported by a research grant with funds provided by the Canadian Institute of Health Research and the Canadian Cancer Society. We thank E. Badalian, H. White, J. Polzer, R. Gaudet, and W. Medved for their contributions to conducting the study interviews.

Funding

None.

Author information

Authors and Affiliations

  1. Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada

    Sierra Cheng, M. Catherine Brown, Hamad Al-Sawaihey & Rayjean J. Hung

  2. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Sierra Cheng

  3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    John R. McLaughlin & Rayjean J. Hung

  4. Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada

    M. Catherine Brown

  5. Department of Surgery, University of Toronto, Toronto, ON, Canada

    James Rutka

  6. Division of Hematology/Oncology, The Hospital for Sick Children Toronto, Toronto, ON, Canada

    Eric Bouffet, Mark Greenberg & David Malkin

  7. Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada

    Cynthia Hawkins

  8. Children’s Hospital, London Health Sciences Centre, London, ON, Canada

    A. Elizabeth Cairney & Adrianna Ranger

  9. McMaster Children’s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada

    Adam J. Fleming

  10. Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Donna Johnston

  11. Pediatric Oncology Group of Ontario, Toronto, ON, Canada

    Mark Greenberg

  12. Department of Medicine, University of Toronto, Toronto, ON, Canada

    Mark Greenberg

  13. Department of Pediatrics, University of University of Toronto, Toronto, ON, Canada

    David Malkin

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Contributions

RJH conceived the study and its design. JRM, MCB, JR, EB, MG and DM contributed to the data collection. SC completed the statistical analysis and drafted the manuscript with RJH and MCB. All authors contributed to study organisation and result interpretation. All authors reviewed the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Rayjean J. Hung.

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Competing interests

The authors declare no competing interests.

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Informed consent was obtained from all participants. The study was approved by the Mount Sinai Hospital Research Ethics Board (REB 20-0055-E).

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Cheng, S., McLaughlin, J.R., Brown, M.C. et al. Maternal and childhood medical history and the risk of childhood brain tumours: a case–control study in Ontario, Canada. Br J Cancer 129, 318–324 (2023). https://doi.org/10.1038/s41416-023-02281-3

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