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Gestational and Familial Risk Factors for Childhood Astrocytoma: Results of a Case-Control Study¹

University of Utrecht, School of Medicine, Utrecht; The Netherlands [R. R. K.]; Children's Hospital of Philadelphia, Division of Oncology, Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania [G. R. B., A. T. M.]; and Maryland Medical Research Institute, Baltimore, Maryland [C. C. N]

Gestational and familial risk factors were investigated for their association with astrocytoma, the most frequently occurring brain tumor in children. A case-control study of 163 matched pairs was performed. Cases under 15 years of age at diagnosis in 1980–1986 were identified through the tumor registries of 8 hospitals in Pennsylvania, New Jersey, and Delaware. Controls were selected by random digit dialing and were matched to cases for age, race, and telephone area code and exchange.

Maternal antinausea medications increased the risk of childhood astrocytoma [OR (odds ratio) = 2.0, P = 0.04]. Cured meat consumption during pregnancy was more common among cases (OR = 1.9, P = 0.07), and a significant trend with increasing frequency of consumption was observed (P = 0.04). Results for gestational exposure to marijuana (OR = 2.8, P = 0.07) were of borderline significance. Gestational exposure to neurally active medications, alcohol, and tobacco were not risk factors. There was a significant trend for cases to be of higher birth weight (P = 0.03).

Mental retardation (OR = 3.0, P = 0.04) and cancer (OR = 1.7, P = 0.02) in a relative of the child significantly increased the risk of astrocytoma. Significantly increased risks were observed for brain tumors in relatives of children 0–4 years of age at diagnosis (OR = 6/0, P = 0.04). A significant protective effect was observed for maternal history of miscarriage or stillbirth (OR = 0.5, P = 0.01).

The results of this study suggest that some gestational and familial factors may increase the risk of childhood astrocytoma.

¹ This research was supported in part by American Cancer Society Grant PDT 315 and the "Stichting de Drie Lichten," The Netherlands. Presented in part at the International Society of Pediatric Oncology SIOP XXI Meeting. Prague, Czechoslovakia, September 18–22, 1989.

² To whom requests for reprints and correspondence should be addressed, at Division of Oncology, Children's Hospital of Philadelphia, 34th and Civic Center Blvd., Room 9093A, Philadelphia, PA 19104.

Received 10/26/89. Revised 1/19/90.

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