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. 1992 Aug 8;305(6849):341–346. doi: 10.1136/bmj.305.6849.341

Childhood cancer, intramuscular vitamin K, and pethidine given during labour.

J Golding 1, R Greenwood 1, K Birmingham 1, M Mott 1
PMCID: PMC1883000  PMID: 1392886

Abstract

OBJECTIVE--To assess unexpected associations between childhood cancer and pethidine given in labour and the neonatal administration of vitamin K that had emerged in a study performed in the 1970 national birth cohort. DESIGN AND SETTING--195 children with cancer diagnosed in 1971-March 1991 and born in the two major Bristol maternity hospitals in 1965-87 were compared with 558 controls identified from the delivery books for the use of pethidine during labour and administration of vitamin K. MAIN OUTCOME MEASURES--Odds ratios for cancer in the presence of administration of pethidine or of intramuscular vitamin K. Both logistic regression and Mantel-Haenszel techniques were used for statistical analyses. RESULTS--Children of mothers given pethidine in labour were not at increased risk of cancer (odds ratio 1.05, 95% confidence interval 0.7 to 1.5) after allowing for year and hospital of delivery, but there was a significant association (p = 0.002) with intramuscular vitamin K (odds ratio 1.97, 95% confidence interval 1.3 to 3.0) when compared with oral vitamin K or no vitamin K. There was no significantly increased risk for children who had been given oral vitamin K when compared with no vitamin K (odds ratio 1.15, 95% confidence interval 0.5 to 2.7). These results could not be accounted for by other factors associated with administration of intramuscular vitamin K, such as type of delivery or admission to a special care baby unit. CONCLUSIONS--The only two studies so far to have examined the relation between childhood cancer and intramuscular vitamin K have shown similar results, and the relation is biologically plausible. The prophylactic benefits against haemorrhagic disease are unlikely to exceed the potential adverse effects from intramuscular vitamin K. Since oral vitamin K has major benefits but no obvious adverse effects this could be the prophylaxis of choice.

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Selected References

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  1. Butler N. R., Golding J., Haslum M., Stewart-Brown S. Recent findings from the 1970 child health and education study: preliminary communication. J R Soc Med. 1982 Oct;75(10):781–784. doi: 10.1177/014107688207501007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cornelissen M., Smeets D., Merkx G., De Abreu R., Kollee L., Monnens L. Analysis of chromosome aberrations and sister chromatid exchanges in peripheral blood lymphocytes of newborns after vitamin K prophylaxis at birth. Pediatr Res. 1991 Dec;30(6):550–553. doi: 10.1203/00006450-199112000-00011. [DOI] [PubMed] [Google Scholar]
  3. Dogra S. C., Israels L. G. Vitamin K1 amplification of benzo(a)pyrene metabolism in chick embryos. Int J Biochem. 1987;19(5):471–473. doi: 10.1016/0020-711x(87)90070-x. [DOI] [PubMed] [Google Scholar]
  4. Gilman E. A., Wilson L. M., Kneale G. W., Waterhouse J. A. Childhood cancers and their association with pregnancy drugs and illnesses. Paediatr Perinat Epidemiol. 1989 Jan;3(1):66–94. doi: 10.1111/j.1365-3016.1989.tb00371.x. [DOI] [PubMed] [Google Scholar]
  5. Golding J. Children of the nineties. A longitudinal study of pregnancy and childhood based on the population of Avon (ALSPAC). West Engl Med J. 1990 Sep;105(3):80–82. [PMC free article] [PubMed] [Google Scholar]
  6. Golding J., Paterson M., Kinlen L. J. Factors associated with childhood cancer in a national cohort study. Br J Cancer. 1990 Aug;62(2):304–308. doi: 10.1038/bjc.1990.283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hilgard P. Experimental vitamin K deficiency and spontaneous metastases. Br J Cancer. 1977 Jun;35(6):891–892. doi: 10.1038/bjc.1977.135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Israels L. G., Friesen E., Jansen A. H., Israels E. D. Vitamin K1 increases sister chromatid exchange in vitro in human leukocytes and in vivo in fetal sheep cells: a possible role for "vitamin K deficiency" in the fetus. Pediatr Res. 1987 Oct;22(4):405–408. doi: 10.1203/00006450-198710000-00008. [DOI] [PubMed] [Google Scholar]
  9. Israels L. G., Walls G. A., Ollmann D. J., Friesen E., Israels E. D. Vitamin K as a regulator of benzo(a)pyrene metabolism, mutagenesis, and carcinogenesis. Studies with rat microsomes and tumorigenesis in mice. J Clin Invest. 1983 May;71(5):1130–1140. doi: 10.1172/JCI110863. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kneale G. W., Stewart A. M. Mantel-Haenszel analysis of Oxford data. I. Independent effects of several birth factors including fetal irradiation. J Natl Cancer Inst. 1976 May;56(5):879–883. doi: 10.1093/jnci/56.5.879. [DOI] [PubMed] [Google Scholar]
  11. McKinney P. A., Cartwright R. A., Saiu J. M., Mann J. R., Stiller C. A., Draper G. J., Hartley A. L., Hopton P. A., Birch J. M., Waterhouse J. A. The inter-regional epidemiological study of childhood cancer (IRESCC): a case control study of aetiological factors in leukaemia and lymphoma. Arch Dis Child. 1987 Mar;62(3):279–287. doi: 10.1136/adc.62.3.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McNinch A. W., Tripp J. H. Haemorrhagic disease of the newborn in the British Isles: two year prospective study. BMJ. 1991 Nov 2;303(6810):1105–1109. doi: 10.1136/bmj.303.6810.1105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McNinch A. W., Upton C., Samuels M., Shearer M. J., McCarthy P., Tripp J. H., L'E Orme R. Plasma concentrations after oral or intramuscular vitamin K1 in neonates. Arch Dis Child. 1985 Sep;60(9):814–818. doi: 10.1136/adc.60.9.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Robins J., Greenland S., Breslow N. E. A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J Epidemiol. 1986 Nov;124(5):719–723. doi: 10.1093/oxfordjournals.aje.a114447. [DOI] [PubMed] [Google Scholar]
  15. Stiller C. A., Draper G. J. Trends in childhood leukaemia in Britain 1968-1978. Br J Cancer. 1982 Apr;45(4):543–551. doi: 10.1038/bjc.1982.90. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Stjernfeldt M., Ludvigsson J., Berglund K., Lindsten J. Maternal smoking during pregnancy and the risk of childhood cancer. Lancet. 1986 Sep 20;2(8508):687–688. doi: 10.1016/s0140-6736(86)90194-7. [DOI] [PubMed] [Google Scholar]
  17. von Kries R. Vitamin K prophylaxis--a useful public health measure? Paediatr Perinat Epidemiol. 1992 Jan;6(1):7–13. doi: 10.1111/j.1365-3016.1992.tb00736.x. [DOI] [PubMed] [Google Scholar]

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