The role of perinatal factors in the appearence of benign and malignant tumours of central nerous system (C.N.S.) in children

Doctoral Dissertation uoadl:1519017 628 Read counter

Unit:
Library of the School of Health Sciences
Τομέας Κοινωνικής Ιατρικής - Ψυχιατρικής και Νευρολογίας
Deposit date:
2017-05-19
Year:
2017
Author:
Plakas Sotirios
Dissertation committee:
Αθηνά Λινού, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Θεοδώρα Ψαλτοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Βασιλική Μπενέτου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Ιωάννης Τούντας, Καθηγητής, Ιατρική, ΕΚΠΑ
Γεώργιος Χρούσος, Καθηγητής, Ιατρική, ΕΚΠΑ
Γεώργιος Στράντζαλης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Στέφανος Κορφιάς, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Η μελέτη του ρόλου προγεννητικών παραγόντων στην εμφάνιση καλοήθων και κακοήθων παθήσεων του κεντρικού νευρικού συστήματος (Κ.Ν.Σ.) στα παιδιά
Languages:
Greek
Translated title:
The role of perinatal factors in the appearence of benign and malignant tumours of central nerous system (C.N.S.) in children
Summary:
OBJECTIVE: The purpose of the study is to highlight the role of perinatal risk factors in the occurrence of benign and malignant diseases of the CNS in children. Prenatal or perinatal risk factors are called the factors affecting the development of the human fetus during pregnancy, from fertilization (preconception phase/conception) to birth. These factors include parents’ age, personal and family history, parental living conditions, parental social behavior, parental occupational exposure; assisted reproduction treatments and maternal exposure to medical drugs during pregnancy, diseases or pathologies that could possibly determine the health of the fetus.
MATERIAL AND METHOD: A case - control study was conducted, at Children's Hospital "Agia Sophia" in Athens from 2007 - 2012 to patients who were treated surgically for a benign or malignant disease of CNS. Based on the frequency of prenatal factors in the general population of healthy children, 100 parents of patients who were treated surgically for a benign or malignant disease of CNS and parents twice the number of controls (by category of disease) were interviewed. For the purposes of the study, patients were divided into four groups: tumors, dysraphism / hydrocephalus, craniosynostosis and other congenital defects. Means, standard deviations, medians and interquartile ranges were used to describe the quantitative variables. Absolute (N) and relative (%) frequencies used for the description of qualitative variables. For the comparison of ratios Pearson's x2 test or Fisher's exact test, where used. For the comparison of quantitative variables between two groups Student's t-test was used. Moreover, in order to find independent factors associated with existence of such lesions, logistic regression analysis was conducted using the sequential process of integration / removal and odd ratios with their 95% confidence intervals (95% CI) emerged. Significance levels are bilaterally and statistical significance was set at 0.05.
RESULTS: Regarding the type of conception (natural or assisted) in the univariate analysis, the OR for developing brain tumors, craniosynostosis and dysraphism / hydrocephalus is 3.2, 3.7 and 4.8 respectively, for children born after IVF fertilization compared to controls. By multivariate logistic regression, having tumor existence as dependent variable, the altitude of residence during pregnancy, the paternal use or contact with industrial solvents or other substances before pregnancy and the region of residence during pregnancy were found to be independently associated with existence of brain tumors in childhood. As regards the existence of dysraphism / hydrocephalus, it was found that the paternal use or contact with industrial solvents or other substances before pregnancy, the maternal exposure to drugs during pregnancy and the intrauterine intracerebral - intraventricular hemorrhage associated independently with such lesions. Furthermore, the maternal use of mobile phone during pregnancy, the maternal exposure to drugs during pregnancy, the maternal progesterone (Utrogestan) intake during pregnancy and the positive history of previous child for CNS disorders were found to be independently associated with craniosynostosis. As regards the existence of other congenital defects, it was found that only the paternal use or contact with industrial solvents or other substances before pregnancy are independently associated with the presence of other congenital birth defects. Finally, children with dysraphism / hydrocephalus or craniosynostosis, are more likely to be born by caesarean section compared to controls, while children with dysraphism / hydrocephalus were found more likely to be born prematurely or to occur premature rupture of membranes (PROM) during pregnancy, compared to controls.
CONCLUSIONS: In conclusion, this study confirmed and reinforced already known risk factors for benign and malignant diseases of the CNS in children and reviewed the role of assisted reproduction treatments in the appearance of CNS defects in children. In addition, our study lays the foundations for evaluating the paternal occupational exposure (use or contact) to industrial solvents or other substances before pregnancy, the maternal progesterone (Utrogestan) intake and the maternal use of mobile phone during pregnancy as an important risk factor for the appearance of hydrocephalus and craniosynostosis in childhood, respectively. Certainly, due to the small number of patients involved in our study, further investigation is needed.
Main subject category:
Health Sciences
Keywords:
Perinatal factors, Brain tumours, Childhood, In vitro fertilization, Perinatal asphyxia
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
1283
Number of pages:
483
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