Parental smoking, maternal alcohol, coffee and tea consumption during pregnancy, and childhood acute leukemia: the ESTELLE study

Cancer Causes Control. 2015 Jul;26(7):1003-17. doi: 10.1007/s10552-015-0593-5. Epub 2015 May 9.


Purpose: To investigate the role of parental smoking during pre-conception and pregnancy, maternal beverage consumption (alcohol, coffee and tea) during pregnancy and their possible interactions, in the etiology of childhood acute leukemia (CL).

Methods: The ESTELLE study included 747 cases of CL [636 cases of acute lymphoblastic leukemia (ALL) and 100 cases of acute myeloblastic leukemia (AML)] diagnosed in France in 2010-2011 and 1,421 population controls frequency-matched with the cases on age and gender. Data were obtained from structured telephone questionnaires administered to the mothers. The odds ratios (OR) and their 95 % confidence intervals were estimated using unconditional logistic regression models adjusted for potential confounders.

Results: AML, but not ALL, was non-significantly associated with alcohol drinking during pregnancy [OR = 1.3 (0.8-2.0)] with a significant positive dose-response trend (p-trend = 0.02). Pre-conception paternal smoking was significantly associated with ALL [OR = 1.2 (1.1-1.5)] and AML [OR = 1.5 (1.0-2.3)]. CL was not associated with maternal smoking [OR = 1.0 (0.8-1.2)], or maternal coffee [OR = 0.9 (0.8-1.1)] or tea drinking [OR = 0.9 (0.8-1.1)] during pregnancy. However, a high consumption of coffee (>2 cups/day) was significantly associated with ALL [OR = 1.3 (1.0-1.8)].

Conclusions: The findings constitute additional evidence that maternal alcohol drinking during pregnancy may be involved in AML, and that paternal smoking before pregnancy may be a risk factor for CL. The role of maternal coffee drinking in CL remains unclear and should be investigated further in consortium analyses and in large birth cohort studies with exposure assessment more contemporaneous with the exposure, before the occurrence of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / epidemiology*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Coffee
  • Female
  • France / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Leukemia, Myeloid, Acute / epidemiology*
  • Logistic Models
  • Male
  • Odds Ratio
  • Parents
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Risk Factors
  • Smoking / epidemiology*
  • Surveys and Questionnaires
  • Tea
  • Tobacco Smoke Pollution / adverse effects*


  • Coffee
  • Tea
  • Tobacco Smoke Pollution