UCLA

Cancer is the second leading cause of mortality among children in the US, with very few well-established preventable causes. Since childhood cancers are diagnosed at an early age, it has been hypothesized that its pathogenesis is initiated during fetal development and possibly fueled by fetal growth. Indeed, population-based studies have linked various perinatal factors with childhood cancers. We investigated preeclampsia, a major cause of adverse effects on fetal health, as a possible risk factor of childhood cancers in a statewide case control study in California. We obtained childhood cancer cases diagnosed at five years old or younger between 1988 and 2012 from the California Cancer Registry and linked them to birth certificates. Controls were randomly selected from all California births and frequency matched to cases by birth year. We obtained information regarding preeclampsia during pregnancy, labor, and delivery from the medical worksheet of the electronic birth record. We applied causal mediation analyses to assess the controlled direct effects of preeclampsia on childhood cancers, independent of preterm delivery and neonatal intensive care unit (NICU) admission. Our findings suggest that maternal preeclampsia increases risk of some rare childhood cancers, including seminomas, teratoma and hepatoblastoma, and may shed light on new etiologic factors for these cancers.

In addition, we examined associations between regular medication use and the risk of age-related macular degeneration (AMD) using a unique data source of the California Teachers Study (CTS), of which 133,479 participants were followed both actively with questionnaires from 1995-1996 until the most recent contact in 2012 and passively with linkage to vital statistics, cancer registries, and hospitalization records. We generated a linked hospital, vital status (including out of state mortality) and baseline questionnaire dataset for each CTS participant. We identified diagnoses of AMD from the California Office of Statewide Health Planning and Development (OSHPD) hospital discharge data. Regular consumption of aspirin, ibuprofen, acetaminophen and antihypertensive medications were collected in the self-administered questionnaire and information on specific antihypertensive drugs and anti-inflammatory drugs were available for subsamples who completed the followup questionnaires in 2000 and 2005 respectively.