{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:21:38Z","timestamp":1789600898838,"version":"build-2803163510"},"reference-count":95,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"New Hampshire Drinking Water and Ground Water Trust Fun"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: To review parental pre-pregnancy and pregnancy exposures in relation to pediatric cancer (diagnosis before age 20). Methods: We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 17 March 2021. Results: Strong evidence links increased risk of childhood cancer with maternal diabetes, age, and alcohol and coffee consumption during pregnancy. Both paternal and maternal cigarette smoking before and during pregnancy are associated with childhood cancers. Diethylstilbestrol (DES) exposure in utero has long been known to be causally associated with increased risk of vaginal\/cervical cancers in adolescent girls. More recent evidence implicates in utero DES exposure to testicular cancer in young men and possible intergenerational effects on ovarian cancer in the granddaughters of women exposed to DES during pregnancy. There is strong evidence that childhood cancer risk is also associated with both high and very low birth weight and with gestational age. Evidence is also strong for the protective effects of maternal vitamin consumption and a healthy diet during pregnancy. Unlike early studies, those reviewed here show no association between in utero exposure to medical ionizing radiation, which may be explained by reductions over time in radiation doses, avoidance of radiation during pregnancy, and\/or by inadequate statistical power to detect small increases in risk, rather than a lack of causal association. Evidence is mixed or conflicting for an association between childhood cancer and maternal obesity, birth order, cesarean\/instrumental delivery, and prenatal exposure to diagnostic medical radiation. Evidence is weak or absent for associations between childhood cancer and multiple gestations or assisted reproductive therapies, as well as prenatal exposure to hormones other than DES, and medications.<\/jats:p>","DOI":"10.3390\/cancers17152499","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T12:39:29Z","timestamp":1753792769000},"page":"2499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Causes of Childhood Cancer: A Review of Literature (2014\u20132021): Part 2\u2014Pregnancy and Birth-Related Factors"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8780-5439","authenticated-orcid":false,"given":"Rebecca T.","family":"Emeny","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Molecular Medicine, UNM Comprehensive Cancer Center, Cancer Control & Population Sciences Research Program, University of New Mexico Health Sciences, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3507-9946","authenticated-orcid":false,"given":"Angela M.","family":"Ricci","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hematology-Oncology, Dartmouth Health Children\u2019s, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0599-3924","authenticated-orcid":false,"given":"Linda","family":"Titus","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Geisel School of Medicine at Dartmouth, Dartmouth Cancer Center, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8531-5762","authenticated-orcid":false,"given":"Alexandra","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dartmouth Health, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1214-7814","authenticated-orcid":false,"given":"Pamela J.","family":"Bagley","sequence":"additional","affiliation":[{"name":"Biomedical Libraries, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather B.","family":"Blunt","sequence":"additional","affiliation":[{"name":"Biomedical Libraries, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Butow","sequence":"additional","affiliation":[{"name":"New Hampshire Department of Health and Human Services, Concord, NH 03302, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2600-446X","authenticated-orcid":false,"given":"Jennifer A.","family":"Alford-Teaster","sequence":"additional","affiliation":[{"name":"New London Hospital Association, New London, NH 03257, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond R. 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