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Exposure to Barbiturates in Utero and during Childhood and Risk of Intracranial and Spinal Cord Tumors¹

Division of Research Kaiser Permanente Medical Care Program, Oakland, California 94611

Barbiturate exposure during childhood was assessed from medical records of 237 children with intracranial and spinal cord tumors and 474 matched controls in a prepaid health plan. In utero exposure was also examined in a subset of 86 "cases" and 172 controls whose mothers were health plan members during pregnancy. No association of in utero exposure to barbiturates was found [odds ratio (O.R.) = 0.96, 95% confidence interval (C.I.) = 0.47, 1.94]. An association was noted for barbiturate use during childhood (O.R. = 1.80, 95% C.I. = 1.18, 2.74) but was reduced (O.R. = 1.41, 95% C.I. = 0.89, 2.21) when history of epilepsy was taken into account and was no longer significant. An apparent dose-response effect disappeared after adjustment for a history of epilepsy. Although barbiturate use for epilepsy due to preexisting brain tumors clearly explains some of the observed association, the small, residual risk prevents us from ruling out a possible carcinogenic effect of barbiturates. Further study of cohorts of adult as well as childhood users of barbiturates and other anticonvulsants is recommended.

¹ Supported by contract NO1-CD-41058 from the National Cancer Institute.

² To whom requests for reprints should be addressed, at 3451 Piedmont Avenue, Oakland CA 94611.

Received 12/12/89. Revised 3/ 9/90.

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