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Maternal supplementation with folic acid and other vitamins and risk of leukemia in offspring: a childhood leukemia international consortium study

Our results suggest that maternal prenatal use of vitamins and folic acid reduces the risk of both ALL and AML

Authors:
Metayer C, Milne E, Dockerty JD, Clavel J, Pombo-de-Oliveira MS, Wesseling C, et al.

Authors notes:
Epidemiology. 2014;25(6):811-822

Keywords:
Childhood cancer, maternal supplements, vitamins, folic acid, risk, ALL, AML

Abstract:
Maternal prenatal supplementation with folic acid and other vitamins has been inconsistently associated with a reduced risk of childhood acute lymphoblastic leukemia (ALL).

Little is known regarding the association with acute myeloid leukemia (AML), a rarer subtype.

Maternal supplements taken any time before conception or during pregnancy were associated with a reduced risk of childhood ALL; odds ratios were 0.85 for vitamin use and 0.80) for folic acid use.

The reduced risk was more pronounced in children whose parents' education was below the highest category.

The analyses for AML led to somewhat unstable estimates; ORs were 0.92 and 0.68 for prenatal vitamins and folic acid, respectively.

There was no strong evidence that risks of either types of leukemia varied by period of supplementation (preconception, pregnancy, or trimester).

Our results, based on the largest number of childhood leukemia cases to date, suggest that maternal prenatal use of vitamins and folic acid reduces the risk of both ALL and AML and that the observed association with ALL varied by parental education, a surrogate for lifestyle and sociodemographic characteristics.