Table 2.
Hazard Ratios for Association Between Perinatal or Family Characteristics and Hodgkin Lymphoma, Sweden, 1973–2009
| Any Hodgkin Lymphoma (n = 943) |
Nodular Sclerosis, Adjusteda (n = 572) |
Mixed Cellularity, Adjusteda (n = 76) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Unadjusted |
Adjusteda |
HR | 95% CI | P Valueb | HR | 95% CI | P Valueb | ||||
| HR | 95% CI | HR | 95% CI | P Valueb | |||||||
| Sex | |||||||||||
| Female | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| Male | 1.02 | 0.90, 1.16 | 1.01 | 0.89, 1.15 | 0.86 | 0.70 | 0.60, 0.83 | <0.001 | 2.62 | 1.57, 4.37 | <0.001 |
| Birth year | |||||||||||
| 1973–1979 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| 1980–1984 | 1.12 | 0.95, 1.32 | 1.09 | 0.92, 1.29 | 1.35 | 1.09, 1.68 | 1.24 | 0.68, 2.23 | |||
| 1985–1989 | 1.09 | 0.89, 1.32 | 1.04 | 0.85, 1.28 | 1.25 | 0.97, 1.63 | 1.26 | 0.63, 2.52 | |||
| 1990–1994 | 1.06 | 0.80, 1.41 | 1.01 | 0.75, 1.34 | 1.26 | 0.87, 1.82 | 1.96 | 0.77, 4.98 | |||
| 1995–1999 | 1.25 | 0.72, 2.16 | 1.16 | 0.67, 2.01 | 2.63 | 1.31, 5.27 | 1.41 | 0.29, 6.92 | |||
| 2000–2004 | 0.27 | 0.04, 1.99 | 0.24 | 0.03, 1.80 | 1.20 | 0.15, 9.61 | NE | ||||
| 2005–2008 | 1.60 | 0.20, 12.85 | 1.70 | 0.21, 13.56 | NE | NE | |||||
| Per each additional category | 1.03 | 0.96, 1.10 | 1.02 | 0.95, 1.09 | 0.81 | 1.12 | 1.02, 1.23 | 0.01 | 1.16 | 0.92, 1.46 | 0.22 |
| Fetal growth, SD | |||||||||||
| <−2 | 0.76 | 0.52, 1.12 | 0.77 | 0.52, 1.13 | 1.00 | 1.00 | |||||
| −2 to <−1 | 0.87 | 0.71, 1.07 | 0.87 | 0.71, 1.07 | 1.08 | 0.65, 1.80 | 2.13 | 0.27, 16.91 | |||
| −1 to <0 | 1.05 | 0.90, 1.23 | 1.04 | 0.89, 1.22 | 1.28 | 0.78, 2.07 | 3.34 | 0.45, 24.71 | |||
| 0 to <1 | 1.00 | Referent | 1.00 | Referent | 1.29 | 0.79, 2.11 | 2.11 | 0.28, 16.07 | |||
| 1 to <2 | 1.24 | 1.01, 1.54 | 1.25 | 1.01, 1.55 | 1.60 | 0.95, 2.70 | 4.63 | 0.60, 35.77 | |||
| ≥2 | 0.97 | 0.64, 1.47 | 0.97 | 0.64, 1.48 | 1.54 | 0.79, 2.98 | 5.29 | 0.58, 48.10 | |||
| Per SD | 1.09 | 1.03, 1.16 | 1.09 | 1.03, 1.16 | 0.005 | 1.12 | 1.04, 1.21 | 0.004 | 1.22 | 0.98, 1.50 | 0.07 |
| Birth weight, g | |||||||||||
| <2,500 | 0.73 | 0.50, 1.08 | 0.51 | 0.31, 0.86 | 0.59 | 0.31, 1.13 | NE | ||||
| 2,500–3,999 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| ≥4,000 | 1.09 | 0.93, 1.29 | 1.09 | 0.93, 1.29 | 1.21 | 0.98, 1.50 | 0.98 | 0.54, 1.77 | |||
| Per 1,000 g | 1.16 | 1.03, 1.30 | 1.24 | 1.09, 1.42 | 0.002 | 1.34 | 1.12, 1.59 | 0.001 | 1.41 | 0.88, 2.24 | 0.15 |
| Birth length, cm | |||||||||||
| <48 | 0.93 | 0.74, 1.17 | 0.86 | 0.66, 1.11 | 0.92 | 0.67, 1.28 | 0.35 | 0.10, 1.20 | |||
| 48–52 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| ≥53 | 1.20 | 1.02, 1.42 | 1.20 | 1.02, 1.42 | 1.32 | 1.06, 1.63 | 1.56 | 0.92, 2.65 | |||
| Per cm | 1.03 | 1.00, 1.06 | 0.03 | 1.01, 1.08 | 0.005 | 1.06 | 1.02, 1.10 | 0.004 | 1.13 | 1.02, 1.26 | 0.02 |
| Ponderal index, g × 100/cm3 | |||||||||||
| <2.60 | 1.00 | 0.86, 1.16 | 0.98 | 0.84, 1.14 | 1.06 | 0.87, 1.30 | 1.19 | 0.71, 1.98 | |||
| 2.60–2.89 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| ≥2.90 | 1.05 | 0.89, 1.23 | 1.06 | 0.90, 1.25 | 1.19 | 0.97, 1.46 | 0.94 | 0.51, 1.72 | |||
| Per 0.10 units | 1.00 | 0.99, 1.02 | 1.01 | 1.00, 1.02 | 0.25 | 1.00 | 0.99, 1.02 | 0.50 | 0.96 | 0.87, 1.05 | 0.34 |
| Gestational age at birth, weeks | |||||||||||
| 22–28 | 0.88 | 0.12, 6.28 | 0.92 | 0.13, 6.56 | 1.50 | 0.21, 10.68 | NE | ||||
| 29–33 | 1.32 | 0.75, 2.33 | 1.38 | 0.78, 2.46 | 1.71 | 0.87, 3.33 | NE | ||||
| 34–36 | 1.07 | 0.79, 1.47 | 1.10 | 0.80, 1.51 | 0.83 | 0.53, 1.33 | 1.93 | 0.82, 4.50 | |||
| 37–42 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| ≥43 | 0.87 | 0.53, 1.42 | 0.92 | 0.56, 1.51 | 0.97 | 0.52, 1.83 | 0.89 | 0.12, 6.50 | |||
| Per week | 1.00 | 0.97, 1.04 | 1.00 | 0.97, 1.04 | 0.86 | 1.02 | 0.97, 1.07 | 0.51 | 0.96 | 0.85, 1.09 | 0.54 |
| Multiple birth | |||||||||||
| Singleton | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| Twin | 0.87 | 0.52, 1.45 | 0.91 | 0.54, 1.54 | 0.72 | 1.05 | 0.55, 2.00 | 0.89 | 0.67 | 0.09, 5.10 | 0.70 |
| Birth order | |||||||||||
| 1 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| 2 | 0.91 | 0.78, 1.05 | 0.87 | 0.74, 1.01 | 0.92 | 0.76, 1.12 | 0.81 | 0.45, 1.45 | |||
| 3 | 1.01 | 0.84, 1.22 | 0.96 | 0.78, 1.18 | 0.94 | 0.72, 1.23 | 1.62 | 0.82, 3.21 | |||
| 4 | 0.74 | 0.51, 1.07 | 0.70 | 0.48, 1.04 | 0.73 | 0.45, 1.19 | 1.37 | 0.44, 4.27 | |||
| ≥5 | 1.14 | 0.72, 1.81 | 1.10 | 0.67, 1.79 | 0.76 | 0.36, 1.58 | 1.64 | 0.35, 7.78 | |||
| Per each additional category | 0.98 | 0.91, 1.05 | 0.96 | 0.88, 1.04 | 0.28 | 0.94 | 0.84, 1.04 | 0.24 | 1.17 | 0.89, 1.54 | 0.25 |
| Maternal age at delivery, years | |||||||||||
| <20 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| 20–24 | 1.06 | 0.72, 1.56 | 1.06 | 0.72, 1.57 | 1.35 | 0.78, 2.35 | 0.48 | 0.18, 1.33 | |||
| 25–29 | 1.17 | 0.80, 1.71 | 1.17 | 0.79, 1.73 | 1.38 | 0.79, 2.40 | 0.41 | 0.15, 1.16 | |||
| 30–34 | 1.12 | 0.76, 1.65 | 1.12 | 0.74, 1.69 | 1.37 | 0.77, 2.44 | 0.37 | 0.12, 1.13 | |||
| 35–39 | 1.27 | 0.84, 1.94 | 1.29 | 0.82, 2.02 | 1.49 | 0.80, 2.79 | 0.43 | 0.12, 1.55 | |||
| ≥40 | 1.18 | 0.63, 2.21 | 1.21 | 0.63, 2.32 | 1.48 | 0.62, 3.54 | 0.57 | 0.10, 3.36 | |||
| Per each additional category | 1.04 | 0.98, 1.11 | 1.04 | 0.97, 1.12 | 0.24 | 1.04 | 0.95, 1.14 | 0.43 | 0.90 | 0.69, 1.17 | 0.44 |
| Maternal education, years | |||||||||||
| ≤9 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| 10–11 | 1.12 | 0.95, 1.33 | 1.11 | 0.94, 1.32 | 1.05 | 0.84, 1.31 | 1.04 | 0.58, 1.85 | |||
| 12–14 | 1.17 | 0.97, 1.41 | 1.11 | 0.91, 1.36 | 1.01 | 0.78, 1.31 | 0.91 | 0.44, 1.88 | |||
| ≥15 | 1.30 | 1.04, 1.62 | 1.17 | 0.91, 1.52 | 1.00 | 0.72, 1.40 | 0.99 | 0.38, 2.56 | |||
| Unknown | 1.04 | 0.74, 1.46 | 1.07 | 0.75, 1.51 | 0.86 | 0.53, 1.38 | 1.01 | 0.30, 3.42 | |||
| Per each additional category | 1.08 | 1.01, 1.16 | 1.04 | 0.96, 1.13 | 0.31 | 0.99 | 0.90, 1.10 | 0.88 | 0.99 | 0.74, 1.32 | 0.94 |
| Paternal education, years | |||||||||||
| ≤9 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| 10–11 | 1.02 | 0.86, 1.21 | 1.03 | 0.86, 1.22 | 1.07 | 0.86, 1.35 | 1.35 | 0.75, 2.42 | |||
| 12–14 | 1.17 | 0.98, 1.40 | 1.13 | 0.94, 1.36 | 1.14 | 0.90, 1.46 | 1.26 | 0.65, 2.45 | |||
| ≥15 | 1.22 | 0.99, 1.49 | 1.11 | 0.88, 1.41 | 1.37 | 1.02, 1.84 | 1.09 | 0.44, 2.68 | |||
| Unknown | 0.89 | 0.64, 1.24 | 0.89 | 0.64, 1.24 | 0.98 | 0.64, 1.49 | 0.26 | 0.03, 1.99 | |||
| Per each additional category | 1.08 | 1.01, 1.15 | 1.05 | 0.98, 1.13 | 0.20 | 1.10 | 1.00, 1.21 | 0.05 | 1.05 | 0.82, 1.36 | 0.68 |
| Hodgkin lymphoma in a sibling | |||||||||||
| No | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| Yes | 9.60 | 3.99, 23.11 | 8.83 | 3.67, 21.30 | <0.001 | 11.51 | 4.29, 30.89 | <0.001 | NE | NE | |
| Hodgkin lymphoma in a parent | |||||||||||
| No | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | |||
| Yes | 7.57 | 3.77, 15.17 | 7.19 | 3.58, 14.44 | <0.001 | 7.33 | 3.03, 17.73 | <0.001 | 11.68 | 1.62, 84.03 | 0.01 |
Abbreviations: CI, confidence interval; HR, hazard ratio; NE, not estimable; SD, standard deviation.
a The adjusted model included sex, birth year, fetal growth, gestational age at birth, multiple birth, birth order, maternal age at delivery, maternal and paternal education levels, and family history of Hodgkin lymphoma in a sibling or parent. Birth weight, birth length, and ponderal index were each examined in separate models as alternatives to the standardized fetal growth variable.
b Ptrend for continuous or ordered polytomous variables and Wald P value for dichotomous variables. Missing parental education data were excluded for trend tests.