Original Article
Childhood Cancer Following Neonatal Oxygen Supplementation

https://doi.org/10.1016/j.jpeds.2005.03.008Get rights and content

Objective

To evaluate the relationship between neonatal oxygen supplementation (O2) and childhood cancer in the Collaborative Perinatal Project (CPP).

Study design

The CPP consisted of 54,795 children born between 1959 and 1966 and followed to age 8 years. We used Cox proportional hazards modeling to examine the association between history of neonatal O2 and cancer (n = 48).

Results

The hazard ratio (HR) for any O2 was 1.77 (95% confidence interval [CI] = 0.94 to 3.35). The HR for continuous duration of O2 was near 1 and not significant. However, the HRs were 0.69 (95% CI = 0.17 to 2.88) and 2.87 (95% CI = 1.46 to 5.66) when comparing 0 to 2 and 3 or more minutes of O2, respectively, to no O2. The latter association was weaker (HR = 2.00; 95% CI = 0.88 to 4.54) and not significant (P = .10) when analysis was restricted to cancers diagnosed after age 1 year (n = 41).

Conclusions

These findings are consistent with an association between O2 for 3 minutes or longer and cancer in childhood, and should serve as a basis for further study.

Section snippets

Methods

The Collaborative Perinatal Project (CPP) enrolled approximately 48,000 women, who had about 60,000 pregnancies, at 12 university-affiliated medical centers between 1959 and 1966; study design and data collection procedures have been described elsewhere.6 Briefly, trained observers in delivery rooms recorded the details of 54,795 live births using a standardized methodology. Children received multiple physical examinations in the first year of life and again at age 7 years. Parents were

Results

Table II summarizes the number of cases, child-months, and hazard ratios (HRs) for the potential confounders. There were no statistically significant associations of cancer with family socioeconomic index, maternal education or age, or child's race, birth weight, or gestational age. Only 1-minute Apgar score < 7 was significantly associated with childhood cancer (HR = 2.22; 95% confidence interval [CI] = 1.19 to 4.13).

Table III summarizes the number of cases, child-months, and HRs for dichotomous O2

Discussion

We found a significantly increased rate of childhood cancer diagnosed between the first week of life and age 8 years among children who received O2 for 3 minutes or longer. This finding was robust to adjustment for various risk factors for childhood cancer.12 The HR for receipt of 3 or more minutes of O2 was not significant (P = .10) but was still elevated when analysis was restricted to cancers diagnosed after age 1 year, to rule out the possibility that O2 was given in response to the symptoms

References (19)

There are more references available in the full text version of this article.

Cited by (0)

Supported by the University of Minnesota Children's Cancer Research Fund.

View full text