Perinatal factors and risk of neuroblastoma

Neuroblastoma is a malignancy commonly diagnosed during infancy or early ch ildhood, raising speculation about the role of perinatal factors and risk o f disease. Using a case-control design, cases included 155 infants and chil dren aged 0-5 years with histologically confirmed neuroblastoma diagnosed a nd reported to the New York State Cancer Registry between 1976 and 1987. Co ntrols were randomly selected h-om the State's Livebirth Registry and were frequency matched to cases on year of birth (n = 310). Medical records of c ases were used to verify histology and stage of disease. Data on perinatal factors were ascertained from birth certificates and standardised telephone interviews with mothers. Unconditional logistic regression was used to est imate (un)adjusted odds ratios (OR) and 95% confidence intervals (CI). Both preterm (< 37 weeks) and post-term (> 42 weeks) birth were associated with a reduction in risk (OR = 0.4 [CI = 0.1, 0.9] and OR = 0.3 [CI = 0.1, 0.7] respectively) after controlling for confounders in unconditional logistic regression analysis. Elevated risk factors included: smoking during pregnan cy (OR = 1.6; CI = 0.9, 2.8), contracted pelvis (OR = 2.3; CI = 0.6, 9.8), birth injury (OR = 2.9; CI = 0.3, 24.9) and 1-min Apgar Score less than or equal to 3 (OR = 6.0; CI = 0.9, 38.6); all confidence intervals included on e. These data suggest that extremes in gestation may be associated with a r educed risk, although aetiological mechanisms remain unknown.