High ambient temperature in pregnancy and risk of childhood acute lymphoblastic leukaemia: an observational study

Details

• Alternative Title:
  Lancet Planet Health
• Personal Author:
  Rogne, Tormod ; Wang, Rong ; Wang, Pin ; Deziel, Nicole C ; Metayer, Catherine ; Wiemels, Joseph L ; Chen, Kai ; Warren, Joshua L ; Ma, Xiaomei
• Description:
  Background
  
  High ambient temperature is increasingly common due to climate change and is associated with risk of adverse pregnancy outcomes. Acute lymphoblastic leukaemia is the most common malignancy in children, the incidence is increasing, and in the USA disproportionately affects Latino children. We aimed to investigate the potential association between high ambient temperature in pregnancy and risk of childhood acute lymphoblastic leukaemia.
  
  Methods
  
  We used data from California birth records (children born from Jan 1, 1982, to Dec 31, 2015) and California Cancer Registry (those diagnosed with childhood cancer in California from Jan 1, 1988, to Dec 31, 2015) to identify acute lymphoblastic leukaemia cases diagnosed in infants and children aged 14 years and younger and controls matched by sex, race, ethnicity, and date of last menstrual period. Ambient temperatures were estimated on a 1-km grid. The association between ambient temperature and acute lymphoblastic leukaemia was evaluated per gestational week, restricted to May–September, adjusting for confounders. Bayesian meta-regression was applied to identify critical exposure windows. For sensitivity analyses, we evaluated a 90-day pre-pregnancy period (assuming no direct effect before pregnancy), adjusted for relative humidity and particulate matter less than 2·5 microns in aerodynamic diameter, and constructed an alternatively matched dataset for exposure contrast by seasonality.
  
  Findings
  
  6849 cases of childhood acute lymphoblastic leukaemia were identified and, of these, 6258 had sufficient data for study inclusion. We also included 307 579 matched controls. Most of the study population were male (174 693 [55·7%] of the 313 837 included in the study) and of Latino ethnicity (174 906 [55·7%]). The peak association between ambient temperature and risk of acute lymphoblastic leukaemia was observed in gestational week 8, where a 5°C increase was associated with an odds ratio of 1·07 (95% CI 1·04–1·11). A slightly larger effect was seen among Latino children (OR 1·09 [95% CI 1·04–1·14]) than non-Latino White children (OR 1·05 [1·00–1·11]). The sensitivity analyses supported the results of the main analysis.
  
  Interpretation
  
  Our findings suggest an association between high ambient temperature in early pregnancy and risk of childhood acute lymphoblastic leukaemia. Further replication and investigation of mechanistic pathways might inform mitigation strategies.
  
  Funding
  
  Yale Center on Climate Change and Health, The National Center for Advancing Translational Science, National Institutes of Health.
  
  
• Subjects:
  Adolescent California Child Child, Preschool Female Hispanic Or Latino Hot Temperature Humans Infant Infant, Newborn Male Precursor Cell Lymphoblastic Leukemia-Lymphoma Pregnancy Risk Factors

  More +
• Source:
  Lancet Planet Health. 8(7):e506-e514
• Pubmed ID:
  38969477
• Pubmed Central ID:
  PMC11260908
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR001863/TR/NCATS NIH HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; R01 ES028346/ES/NIEHS NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; P30 CA016359/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/
• Volume:
  8
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0ed2e4d3f52b7da302b700761e876c49c3ac4260dd5506bf0c6980c97ad09917d1e5e52cc7c1585b599be4f06b6e449f99a4dfef0ecbdaa06ca8976d5a9090ca
• Download URL:
  https://stacks.cdc.gov/view/cdc/159328/cdc_159328_DS1.pdf
• File Type:
  [PDF - 403.94 KB ]