{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:38:06Z","timestamp":1784036286407,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T00:00:00Z","timestamp":1588118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007903","name":"Bloodwise","doi-asserted-by":"publisher","award":["15037"],"award-info":[{"award-number":["15037"]}],"id":[{"id":"10.13039\/501100007903","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Reports have suggested that children born by caesarean initiated before labour onset may be at increased risk of developing acute lymphoblastic leukaemia (ALL). However, with most data being derived from case\u2010control study interviews, information on the underpinning reasons for caesarean section is sparse, and evidence is conflicting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Use clinical records compiled at the time of delivery to investigate the association between childhood ALL and caesarean delivery; examining timing in relation to labour onset, and reasons for the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data are from the UK Childhood Cancer Study, a population\u2010based case\u2010control study conducted in the 1990s, when caesarean section rates were relatively low, in England, Scotland, and Wales. Children with ALL were individually matched to two controls on sex, date of birth, and region of residence. Information on mode of delivery and complications was abstracted from obstetric records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression models adjusted for matching variables and relevant covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Around 75% of the 1034 cases and 1914 controls were born through unassisted vaginal delivery. Caesarean delivery was as frequent in cases and controls (OR 1.07, 95% CI 0.84, 1.36). No association was observed between ALL and caesarean delivery either during or before labour, with adjusted ORs of 1.08 (95% CI 0.78, 1.48) and 1.09 (95% CI 0.78, 1.53), respectively. For B\u2010cell ALL, the ORs were 1.14 (95% CI 0.81, 1.59) for caesarean during labour and 1.21 (95% CI 0.85, 1.72) for prelabour. The underpinning reasons for caesarean delivery differed between cases and controls; with preeclampsia, although very rare, being more common amongst cases born by caesarean (OR 8.91, 95% CI 1.48, 53.42).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our obstetric record\u2010based study found no significant evidence that caesarean delivery increased the risk of childhood ALL, either overall or when carried out before labour.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12662","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T09:18:47Z","timestamp":1588151927000},"page":"344-349","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Paediatric acute lymphoblastic leukaemia and caesarean section: A report from the United Kingdom Childhood Cancer Study (UKCCS)"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6665-8145","authenticated-orcid":false,"given":"Audrey","family":"Bonaventure","sequence":"first","affiliation":[{"name":"Epidemiology and Cancer Statistics Group Department of Health Sciences University of York York UK"},{"name":"CRESS Universit\u00e9 de Paris INSERM UMR 1153 Epidemiology of Childhood and Adolescent Cancers Team Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Simpson","sequence":"additional","affiliation":[{"name":"Epidemiology and Cancer Statistics Group Department of Health Sciences University of York York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pat","family":"Ansell","sequence":"additional","affiliation":[{"name":"Epidemiology and Cancer Statistics Group Department of Health Sciences University of York York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Roman","sequence":"additional","affiliation":[{"name":"Epidemiology and Cancer Statistics Group Department of Health Sciences University of York York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,29]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Swerdlow S","year":"2017"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2004.10.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.7.603"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2006.00731.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-8-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/87.12.908"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.53"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-1098"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12667"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19910915)68:6<1351::AID-CNCR2820680627>3.0.CO;2-J"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kww153"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-17-0778"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000151"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(16)00002-8"},{"issue":"41","key":"e_1_2_8_16_1","first-page":"749","article-title":"Perinatal and reproductive factors: a report on haematological malignancies from the UKCCS","volume":"2005","author":"Roman E","year":"1990","journal-title":"European Journal of Cancer (Oxford, England"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000160429.22836.c0"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31928-7"},{"key":"e_1_2_8_19_1","unstructured":"DigitalNHS.Maternity Services Monthly Statistics January 2019 Experimental statistics. https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/maternity\u2010services\u2010monthly\u2010statistics\/january\u20102019. 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