Application of an obstetric comorbidity index to predict childhood cancer risk: a population based case-control study in Denmark

Br J Cancer. 2025 Oct;133(6):856-864. doi: 10.1038/s41416-025-03120-3. Epub 2025 Jul 21.

Abstract

Background: Maternal health during pregnancy appears to impact childhood cancer risk, yet comprehensive studies remain scarce. This study investigates associations between childhood cancer and multiple maternal comorbidities.

Methods: A population-based case-control study was conducted using Danish national registers, with maternal health conditions identified from the National Patient Register and Medical Births Registry. We employed the Obstetric Comorbidity Index using ICD-8 and ICD-10 codes. The study population (1977-2013) included 6419 cases and 160484 matched controls. Conditional logistic regression estimated pediatric cancer risk.

Results: A maternal comorbidity score of one or more was linked to acute lymphocytic leukemia (ALL; OR = 1.07, 95%CI: 1.03-1.12), retinoblastoma (OR = 1.08, 95%CI: 0.94-1.23), and rhabdomyosarcoma (OR = 1.11, 95%CI: 0.98-1.26). Pre-existing diabetes (OR = 1.82, 95%CI: 1.28-2.59), previous cesarean delivery (OR = 1.20, 95%CI: 1.02-1.41), and gestational hypertension (OR = 1.27, 95%CI: 1.01-1.59) were associated with increased cancer risks in offspring. Slightly higher risks were noted for non-Hodgkin lymphoma (OR = 1.05, 95%CI: 0.96-1.16) and Burkitt lymphoma (OR = 1.08, 95%CI: 0.92-1.27) among children whose mothers had one or more comorbidities.

Conclusion: An obstetric comorbidity index can predict childhood cancer risk. This highlights the need for targeted interventions to reduce adverse health consequences for offspring.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Comorbidity
  • Denmark / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Neoplasms* / epidemiology
  • Pregnancy
  • Registries
  • Risk Factors
  • Young Adult