{"doi":"10.1093/ije/dyab199","title":"Common maternal infections during pregnancy and childhood leukaemia in the offspring: findings from six international birth cohorts","abstract":"BACKGROUND: Previous epidemiological studies have found positive associations between maternal infections and childhood leukaemia; however, evidence from prospective cohort studies is scarce. We aimed to examine the associations using large-scale prospective data. METHODS: Data were pooled from six population-based birth cohorts in Australia, Denmark, Israel, Norway, the UK and the USA (recruitment 1950s-2000s). Primary outcomes were any childhood leukaemia and acute lymphoblastic leukaemia (ALL); secondary outcomes were acute myeloid leukaemia (AML) and any childhood cancer. Exposures included maternal self-reported infections [influenza-like illness, common cold, any respiratory tract infection, vaginal thrush, vaginal infections and urinary tract infection (including cystitis)] and infection-associated symptoms (fever and diarrhoea) during pregnancy. Covariate-adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using multilevel Cox models. RESULTS: Among 312 879 children with a median follow-up of 13.6 years, 167 leukaemias, including 129 ALL and 33 AML, were identified. Maternal urinary tract infection was associated with increased risk of any leukaemia [HR (95% CI) 1.68 (1.10-2.58)] and subtypes ALL [1.49 (0.87-2.56)] and AML [2.70 ([0.93-7.86)], but not with any cancer [1.13 (0.85-1.51)]. Respiratory tract infection was associated with increased risk of any leukaemia [1.57 (1.06-2.34)], ALL [1.43 (0.94-2.19)], AML [2.37 (1.10-5.12)] and any cancer [1.33 (1.09-1.63)]; influenza-like illness showed a similar pattern but with less precise estimates. There was no evidence of a link between other infections and any outcomes. CONCLUSIONS: Urinary tract and respiratory tract infections during pregnancy may be associated with childhood leukaemia, but the absolute risk is small given the rarity of the outcome.","journal":"International Journal of Epidemiology","year":2021,"id":171889,"datarank":0.8503223127643648,"base_score":3.295836866004329,"endowment":3.295836866004329,"self_citation_contribution":0.4943755299006494,"citation_network_contribution":0.35594678286371534,"self_endowment_contribution":0.4943755299006494,"citer_contribution":0.35594678286371534,"corpus_percentile":76.34408602150538,"corpus_rank":3059,"citation_count":26,"citer_count":23,"citers_with_citation_signal":14,"citers_with_endowment":14,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.662,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":707301,"name":"Jane E. Hirst","orcid":"0000-0002-0176-2651","position":1,"is_corresponding":false},{"id":374871,"name":"Gabriella Tikellis","orcid":"0000-0002-5154-6658","position":2,"is_corresponding":false},{"id":365157,"name":"Gary Phillips","orcid":null,"position":3,"is_corresponding":false},{"id":707302,"name":"Rema Ramakrishnan","orcid":"0000-0002-6784-8319","position":4,"is_corresponding":false},{"id":374873,"name":"Ora Paltiel","orcid":"0000-0001-8324-3873","position":5,"is_corresponding":false},{"id":40716,"name":"Anne-Louise Ponsonby","orcid":"0000-0002-6581-3657","position":6,"is_corresponding":false},{"id":375622,"name":"Mark A. Klebanoff","orcid":null,"position":7,"is_corresponding":false},{"id":402172,"name":"Jørn Olsen","orcid":"0000-0001-7462-2740","position":8,"is_corresponding":false},{"id":707303,"name":"Michael Murphy","orcid":"0000-0002-2375-7503","position":9,"is_corresponding":false},{"id":5169,"name":"Siri E. Håberg","orcid":"0000-0002-2199-5225","position":10,"is_corresponding":false},{"id":73759,"name":"Stanley Lemeshow","orcid":null,"position":11,"is_corresponding":false},{"id":308447,"name":"Sjúrđur F. Olsen","orcid":"0000-0003-3017-7096","position":12,"is_corresponding":false},{"id":707304,"name":"Xiu Qiu","orcid":"0000-0003-1248-229X","position":13,"is_corresponding":false},{"id":104444,"name":"Per Magnus","orcid":"0000-0002-6427-4735","position":14,"is_corresponding":false},{"id":1516,"name":"Jean Golding","orcid":"0000-0003-2826-3307","position":15,"is_corresponding":false},{"id":282614,"name":"Mary H. Ward","orcid":"0000-0001-7584-8856","position":16,"is_corresponding":false},{"id":409685,"name":"Joseph L. Wiemels","orcid":"0000-0003-4838-9951","position":17,"is_corresponding":false},{"id":23235,"name":"Kazem Rahimi","orcid":"0000-0002-4807-4610","position":18,"is_corresponding":false},{"id":251241,"name":"Martha S. Linet","orcid":"0000-0002-1687-5587","position":19,"is_corresponding":false},{"id":310333,"name":"Terence Dwyer","orcid":"0000-0002-2091-7663","position":20,"is_corresponding":false},{"id":707300,"name":"Jianrong He","orcid":"0000-0003-3837-5126","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T23:46:37.150824Z","pmid":"34519790","pmcid":"PMC9425514","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}