Maternal use of hormonal contraception and risk of childhood leukemia: A Scandinavian population-based cohort study
Maternal hormonal contraception use has been associated with childhood leukemia risk. However, studies are few and often based on self-reported information. Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996–2018) and followed them from birth until leuk...
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| Veröffentlicht in: | European journal of cancer (1990) 2025-01, Vol.215, p.115168, Article 115168 |
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| creator | Hemmingsen, Caroline H. Kjaer, Susanne K. Hjorth, Sarah Nörby, Ulrika Broe, Anne Pottegård, Anton Bénévent, Justine Schmiegelow, Kjeld Skovlund, Charlotte Wessel Leinonen, Maarit K. Nordeng, Hedvig Mørch, Lina S. Hargreave, Marie |
| description | Maternal hormonal contraception use has been associated with childhood leukemia risk. However, studies are few and often based on self-reported information.
Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996–2018) and followed them from birth until leukemia diagnosis, censoring (death, emigration, other cancer, 20th birthday) or study closure (December 31st, 2017, 2018 or 2020). We estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for childhood leukemia (any, lymphoid and non-lymphoid) associated with maternal recent use (≤ 3 months before or during pregnancy) or previous use (before recent use) of hormonal contraception overall and by type, compared to no use.
During 29,455,528 person-years, 1701 children developed leukemia (no use: 518, previous use: 974, recent use: 209). Maternal recent use of hormonal contraception was associated with an increased leukemia risk in children (HR 1.22, 95 % CI 1.04–1.44; incidence rate per 1,000,000 person-years [IR] 65), compared to no use (IR 53). The association was strongest for non-lymphoid leukemia (HR 1.69, 95 % CI 1.20–2.37) and mainly driven by the oral combined products, both for any leukemia (HR 1.29, 95 % CI 1.05–1.59) and non-lymphoid leukemia (HR 1.75, 95 % CI 1.17–2.62). Additionally, non-lymphoid leukemia was associated with recent use of the non-oral progestin-only products (HR 2.10, 95 % CI 1.28–3.44).
Although the absolute risk was low, maternal hormonal contraception use up to or during pregnancy was associated with an increased childhood leukemia risk, particularly non-lymphoid leukemia, and mainly driven by oral combined and non-oral progestin-only products.
•Maternal hormonal contraception linked to higher childhood leukemia risk.•Association strongest when used close to or during pregnancy.•Risk increase mainly observed for non-lymphoid leukemia.•Primarily associated with oral combined and non-oral progestin-only contraceptives. |
| doi_str_mv | 10.1016/j.ejca.2024.115168 |
| format | Article |
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Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996–2018) and followed them from birth until leukemia diagnosis, censoring (death, emigration, other cancer, 20th birthday) or study closure (December 31st, 2017, 2018 or 2020). We estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for childhood leukemia (any, lymphoid and non-lymphoid) associated with maternal recent use (≤ 3 months before or during pregnancy) or previous use (before recent use) of hormonal contraception overall and by type, compared to no use.
During 29,455,528 person-years, 1701 children developed leukemia (no use: 518, previous use: 974, recent use: 209). Maternal recent use of hormonal contraception was associated with an increased leukemia risk in children (HR 1.22, 95 % CI 1.04–1.44; incidence rate per 1,000,000 person-years [IR] 65), compared to no use (IR 53). The association was strongest for non-lymphoid leukemia (HR 1.69, 95 % CI 1.20–2.37) and mainly driven by the oral combined products, both for any leukemia (HR 1.29, 95 % CI 1.05–1.59) and non-lymphoid leukemia (HR 1.75, 95 % CI 1.17–2.62). Additionally, non-lymphoid leukemia was associated with recent use of the non-oral progestin-only products (HR 2.10, 95 % CI 1.28–3.44).
Although the absolute risk was low, maternal hormonal contraception use up to or during pregnancy was associated with an increased childhood leukemia risk, particularly non-lymphoid leukemia, and mainly driven by oral combined and non-oral progestin-only products.
•Maternal hormonal contraception linked to higher childhood leukemia risk.•Association strongest when used close to or during pregnancy.•Risk increase mainly observed for non-lymphoid leukemia.•Primarily associated with oral combined and non-oral progestin-only contraceptives.</description><identifier>ISSN: 0959-8049</identifier><identifier>ISSN: 1879-0852</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2024.115168</identifier><identifier>PMID: 39667251</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Child ; Child, Preschool ; Childhood cancer ; Cohort Studies ; Cohort study ; Contraceptives, Oral, Hormonal - adverse effects ; Denmark - epidemiology ; Female ; Hormonal contraception ; Hormonal Contraception - adverse effects ; Humans ; Incidence ; Infant ; Infant, Newborn ; Leukemia ; Leukemia - chemically induced ; Leukemia - epidemiology ; Male ; Norway - epidemiology ; Pharmacoepidemiology ; Pregnancy ; Prenatal Exposure Delayed Effects - chemically induced ; Prenatal Exposure Delayed Effects - epidemiology ; Registries ; Risk Factors ; Scandinavia ; Scandinavian and Nordic Countries - epidemiology ; Sweden - epidemiology ; Young Adult</subject><ispartof>European journal of cancer (1990), 2025-01, Vol.215, p.115168, Article 115168</ispartof><rights>2024 Elsevier Ltd</rights><rights>Copyright © 2024 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-9565f967deefa93c5af9ca4222c952c9f9674c6d3c7cdee9ad9e40082f8de8fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0959804924017751$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39667251$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hemmingsen, Caroline H.</creatorcontrib><creatorcontrib>Kjaer, Susanne K.</creatorcontrib><creatorcontrib>Hjorth, Sarah</creatorcontrib><creatorcontrib>Nörby, Ulrika</creatorcontrib><creatorcontrib>Broe, Anne</creatorcontrib><creatorcontrib>Pottegård, Anton</creatorcontrib><creatorcontrib>Bénévent, Justine</creatorcontrib><creatorcontrib>Schmiegelow, Kjeld</creatorcontrib><creatorcontrib>Skovlund, Charlotte Wessel</creatorcontrib><creatorcontrib>Leinonen, Maarit K.</creatorcontrib><creatorcontrib>Nordeng, Hedvig</creatorcontrib><creatorcontrib>Mørch, Lina S.</creatorcontrib><creatorcontrib>Hargreave, Marie</creatorcontrib><title>Maternal use of hormonal contraception and risk of childhood leukemia: A Scandinavian population-based cohort study</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Maternal hormonal contraception use has been associated with childhood leukemia risk. However, studies are few and often based on self-reported information.
Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996–2018) and followed them from birth until leukemia diagnosis, censoring (death, emigration, other cancer, 20th birthday) or study closure (December 31st, 2017, 2018 or 2020). We estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for childhood leukemia (any, lymphoid and non-lymphoid) associated with maternal recent use (≤ 3 months before or during pregnancy) or previous use (before recent use) of hormonal contraception overall and by type, compared to no use.
During 29,455,528 person-years, 1701 children developed leukemia (no use: 518, previous use: 974, recent use: 209). Maternal recent use of hormonal contraception was associated with an increased leukemia risk in children (HR 1.22, 95 % CI 1.04–1.44; incidence rate per 1,000,000 person-years [IR] 65), compared to no use (IR 53). The association was strongest for non-lymphoid leukemia (HR 1.69, 95 % CI 1.20–2.37) and mainly driven by the oral combined products, both for any leukemia (HR 1.29, 95 % CI 1.05–1.59) and non-lymphoid leukemia (HR 1.75, 95 % CI 1.17–2.62). Additionally, non-lymphoid leukemia was associated with recent use of the non-oral progestin-only products (HR 2.10, 95 % CI 1.28–3.44).
Although the absolute risk was low, maternal hormonal contraception use up to or during pregnancy was associated with an increased childhood leukemia risk, particularly non-lymphoid leukemia, and mainly driven by oral combined and non-oral progestin-only products.
•Maternal hormonal contraception linked to higher childhood leukemia risk.•Association strongest when used close to or during pregnancy.•Risk increase mainly observed for non-lymphoid leukemia.•Primarily associated with oral combined and non-oral progestin-only contraceptives.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Childhood cancer</subject><subject>Cohort Studies</subject><subject>Cohort study</subject><subject>Contraceptives, Oral, Hormonal - adverse effects</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>Hormonal contraception</subject><subject>Hormonal Contraception - adverse effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Leukemia</subject><subject>Leukemia - chemically induced</subject><subject>Leukemia - epidemiology</subject><subject>Male</subject><subject>Norway - epidemiology</subject><subject>Pharmacoepidemiology</subject><subject>Pregnancy</subject><subject>Prenatal Exposure Delayed Effects - chemically induced</subject><subject>Prenatal Exposure Delayed Effects - epidemiology</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Scandinavia</subject><subject>Scandinavian and Nordic Countries - epidemiology</subject><subject>Sweden - epidemiology</subject><subject>Young Adult</subject><issn>0959-8049</issn><issn>1879-0852</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAQhi0EokvbF-CAfOSSxXZiJ0ZcqooWpCIOwNmajidab5M42Emlvj2OtnDkMLJG_v5Pmp-xt1LspZDmw3FPR4S9EqrZS6ml6V6wnexaW4lOq5dsJ6y2VScae8be5HwUQrRdI16zs9oa0yotdyx_g4XSBANfM_HY80NMY9x2jNOSAGleQpw4TJ6nkB82BA9h8IcYPR9ofaAxwEd-xX9gYcIEjwEmPsd5HWBLVveQyRdbES88L6t_umCvehgyXT6_5-zXzeef11-qu--3X6-v7ipUdbtUVhvdW9N6oh5sjRp6i9AopdDqMttfg8bX2GJhLHhLjRCd6jtPXU_1OXt_8s4p_l4pL24MGWkYYKK4ZlfLxhhTN7otqDqhmGLOiXo3pzBCenJSuK1sd3Rb2W4r253KLqF3z_71fiT_L_K33QJ8OgFUrnwMlFzGQBOSD4lwcT6G__n_AAUKktA</recordid><startdate>20250117</startdate><enddate>20250117</enddate><creator>Hemmingsen, Caroline H.</creator><creator>Kjaer, Susanne K.</creator><creator>Hjorth, Sarah</creator><creator>Nörby, Ulrika</creator><creator>Broe, Anne</creator><creator>Pottegård, Anton</creator><creator>Bénévent, Justine</creator><creator>Schmiegelow, Kjeld</creator><creator>Skovlund, Charlotte Wessel</creator><creator>Leinonen, Maarit K.</creator><creator>Nordeng, Hedvig</creator><creator>Mørch, Lina S.</creator><creator>Hargreave, Marie</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20250117</creationdate><title>Maternal use of hormonal contraception and risk of childhood leukemia: A Scandinavian population-based cohort study</title><author>Hemmingsen, Caroline H. ; Kjaer, Susanne K. ; Hjorth, Sarah ; Nörby, Ulrika ; Broe, Anne ; Pottegård, Anton ; Bénévent, Justine ; Schmiegelow, Kjeld ; Skovlund, Charlotte Wessel ; Leinonen, Maarit K. ; Nordeng, Hedvig ; Mørch, Lina S. ; Hargreave, Marie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-9565f967deefa93c5af9ca4222c952c9f9674c6d3c7cdee9ad9e40082f8de8fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Childhood cancer</topic><topic>Cohort Studies</topic><topic>Cohort study</topic><topic>Contraceptives, Oral, Hormonal - adverse effects</topic><topic>Denmark - epidemiology</topic><topic>Female</topic><topic>Hormonal contraception</topic><topic>Hormonal Contraception - adverse effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Leukemia</topic><topic>Leukemia - chemically induced</topic><topic>Leukemia - epidemiology</topic><topic>Male</topic><topic>Norway - epidemiology</topic><topic>Pharmacoepidemiology</topic><topic>Pregnancy</topic><topic>Prenatal Exposure Delayed Effects - chemically induced</topic><topic>Prenatal Exposure Delayed Effects - epidemiology</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Scandinavia</topic><topic>Scandinavian and Nordic Countries - epidemiology</topic><topic>Sweden - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hemmingsen, Caroline H.</creatorcontrib><creatorcontrib>Kjaer, Susanne K.</creatorcontrib><creatorcontrib>Hjorth, Sarah</creatorcontrib><creatorcontrib>Nörby, Ulrika</creatorcontrib><creatorcontrib>Broe, Anne</creatorcontrib><creatorcontrib>Pottegård, Anton</creatorcontrib><creatorcontrib>Bénévent, Justine</creatorcontrib><creatorcontrib>Schmiegelow, Kjeld</creatorcontrib><creatorcontrib>Skovlund, Charlotte Wessel</creatorcontrib><creatorcontrib>Leinonen, Maarit K.</creatorcontrib><creatorcontrib>Nordeng, Hedvig</creatorcontrib><creatorcontrib>Mørch, Lina S.</creatorcontrib><creatorcontrib>Hargreave, Marie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hemmingsen, Caroline H.</au><au>Kjaer, Susanne K.</au><au>Hjorth, Sarah</au><au>Nörby, Ulrika</au><au>Broe, Anne</au><au>Pottegård, Anton</au><au>Bénévent, Justine</au><au>Schmiegelow, Kjeld</au><au>Skovlund, Charlotte Wessel</au><au>Leinonen, Maarit K.</au><au>Nordeng, Hedvig</au><au>Mørch, Lina S.</au><au>Hargreave, Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal use of hormonal contraception and risk of childhood leukemia: A Scandinavian population-based cohort study</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2025-01-17</date><risdate>2025</risdate><volume>215</volume><spage>115168</spage><pages>115168-</pages><artnum>115168</artnum><issn>0959-8049</issn><issn>1879-0852</issn><eissn>1879-0852</eissn><abstract>Maternal hormonal contraception use has been associated with childhood leukemia risk. However, studies are few and often based on self-reported information.
Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996–2018) and followed them from birth until leukemia diagnosis, censoring (death, emigration, other cancer, 20th birthday) or study closure (December 31st, 2017, 2018 or 2020). We estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for childhood leukemia (any, lymphoid and non-lymphoid) associated with maternal recent use (≤ 3 months before or during pregnancy) or previous use (before recent use) of hormonal contraception overall and by type, compared to no use.
During 29,455,528 person-years, 1701 children developed leukemia (no use: 518, previous use: 974, recent use: 209). Maternal recent use of hormonal contraception was associated with an increased leukemia risk in children (HR 1.22, 95 % CI 1.04–1.44; incidence rate per 1,000,000 person-years [IR] 65), compared to no use (IR 53). The association was strongest for non-lymphoid leukemia (HR 1.69, 95 % CI 1.20–2.37) and mainly driven by the oral combined products, both for any leukemia (HR 1.29, 95 % CI 1.05–1.59) and non-lymphoid leukemia (HR 1.75, 95 % CI 1.17–2.62). Additionally, non-lymphoid leukemia was associated with recent use of the non-oral progestin-only products (HR 2.10, 95 % CI 1.28–3.44).
Although the absolute risk was low, maternal hormonal contraception use up to or during pregnancy was associated with an increased childhood leukemia risk, particularly non-lymphoid leukemia, and mainly driven by oral combined and non-oral progestin-only products.
•Maternal hormonal contraception linked to higher childhood leukemia risk.•Association strongest when used close to or during pregnancy.•Risk increase mainly observed for non-lymphoid leukemia.•Primarily associated with oral combined and non-oral progestin-only contraceptives.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>39667251</pmid><doi>10.1016/j.ejca.2024.115168</doi></addata></record> |
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| ispartof | European journal of cancer (1990), 2025-01, Vol.215, p.115168, Article 115168 |
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| subjects | Adolescent Adult Child Child, Preschool Childhood cancer Cohort Studies Cohort study Contraceptives, Oral, Hormonal - adverse effects Denmark - epidemiology Female Hormonal contraception Hormonal Contraception - adverse effects Humans Incidence Infant Infant, Newborn Leukemia Leukemia - chemically induced Leukemia - epidemiology Male Norway - epidemiology Pharmacoepidemiology Pregnancy Prenatal Exposure Delayed Effects - chemically induced Prenatal Exposure Delayed Effects - epidemiology Registries Risk Factors Scandinavia Scandinavian and Nordic Countries - epidemiology Sweden - epidemiology Young Adult |
| title | Maternal use of hormonal contraception and risk of childhood leukemia: A Scandinavian population-based cohort study |
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