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Journal Article Observational Study Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. Ppublish 11 citations

PubMed: 38969477 DOI: 10.1016/S2542-5196(24)00121-9

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

Lancet Planet Health 8(7):e506-e514

Authors: Tormod Rogne, Rong Wang, Pin Wang, Nicole C Deziel, Catherine Metayer, Joseph L Wiemels, Kai Chen, Joshua L Warren, Xiaomei Ma

Affiliations

  • Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA; Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA.
  • Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
  • Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
  • School of Public Health, University of California, Berkeley, CA, USA.
  • Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.

Abstract

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.

MeSH

Pregnancy, Global Health, Neoplasms, Environmental Health, Temperature, Child

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