OBJECTIVE: Prior epidemiological studies suggest a possible association between maternal smoking during pregnancy and risk of childhood brain tumors. A meta-analysis was performed statistically pooling all available observational studies on this topic in order to evaluate this suspected association. METHODS: Using previously described methods, a protocol was developed for a meta-analysis examining the association between maternal smoking during pregnancy and subsequent development of primary brain tumors in their offspring. Literature search techniques, study inclusion criteria and statistical procedures were prospectively defined. Data from epidemiological studies were pooled using a general variance-based meta-analytic method employing confidence intervals previously described by Greenland. The outcome of interest was a summary relative risk (RRs) reflecting the risk of childhood brain tumor development associated with mother's smoking during the index pregnancy. Sensitivity analyses were performed when necessary to explain any observed statistical heterogeneity and/or to evaluate the impact of demographic or study characteristics on the summary estimate of effect. RESULTS: Twelve observational studies meeting protocol specified inclusion criteria were obtained via a comprehensive literature search. These studies enrolled a total of 6566 patients. Analysis for homogeneity demonstrated that the data were homogeneous (P > 0.50) and could be statistically combined. Pooling all twelve reports yielded an RRs of 1.05 (0.90-1.21), a non-statistically significant result suggesting no clear association between maternal smoking during pregnancy and risk of childhood brain tumor development. Numerous sensitivity analyses examining the possible effect of study design and various patient characteristics failed to show any influence on the RRs further supporting the observed lack of association. CONCLUSION: The available epidemiological data do not support a clear association between maternal smoking during pregnancy and pediatric brain tumor development. Although it appears likely that no association exists, limitations in study designs limit definitive conclusions based on available data.
OBJECTIVE: Prior epidemiological studies suggest a possible association between maternal smoking during pregnancy and risk of childhood brain tumors. A meta-analysis was performed statistically pooling all available observational studies on this topic in order to evaluate this suspected association. METHODS: Using previously described methods, a protocol was developed for a meta-analysis examining the association between maternal smoking during pregnancy and subsequent development of primary brain tumors in their offspring. Literature search techniques, study inclusion criteria and statistical procedures were prospectively defined. Data from epidemiological studies were pooled using a general variance-based meta-analytic method employing confidence intervals previously described by Greenland. The outcome of interest was a summary relative risk (RRs) reflecting the risk of childhood brain tumor development associated with mother's smoking during the index pregnancy. Sensitivity analyses were performed when necessary to explain any observed statistical heterogeneity and/or to evaluate the impact of demographic or study characteristics on the summary estimate of effect. RESULTS: Twelve observational studies meeting protocol specified inclusion criteria were obtained via a comprehensive literature search. These studies enrolled a total of 6566 patients. Analysis for homogeneity demonstrated that the data were homogeneous (P > 0.50) and could be statistically combined. Pooling all twelve reports yielded an RRs of 1.05 (0.90-1.21), a non-statistically significant result suggesting no clear association between maternal smoking during pregnancy and risk of childhood brain tumor development. Numerous sensitivity analyses examining the possible effect of study design and various patient characteristics failed to show any influence on the RRs further supporting the observed lack of association. CONCLUSION: The available epidemiological data do not support a clear association between maternal smoking during pregnancy and pediatric brain tumor development. Although it appears likely that no association exists, limitations in study designs limit definitive conclusions based on available data.
Authors: J M Birch; A L Hartley; M D Teare; V Blair; P A McKinney; J R Mann; C A Stiller; G J Draper; H E Johnston; R A Cartwright Journal: Br J Neurosurg Date: 1990 Impact factor: 1.596
Authors: Fritz Horak; Tamas Fazekas; Angela Zacharasiewicz; Ernst Eber; Herbert Kiss; Alfred Lichtenschopf; Manfred Neuberger; Rudolf Schmitzberger; Burkhard Simma; Andree Wilhelm-Mitteräcker; Josef Riedler Journal: Wien Klin Wochenschr Date: 2011-12-22 Impact factor: 1.704
Authors: Kimberly J Johnson; Jennifer Cullen; Jill S Barnholtz-Sloan; Quinn T Ostrom; Chelsea E Langer; Michelle C Turner; Roberta McKean-Cowdin; James L Fisher; Philip J Lupo; Sonia Partap; Judith A Schwartzbaum; Michael E Scheurer Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-09-05 Impact factor: 4.254
Authors: Jessica L Barrington-Trimis; Susan Searles Nielsen; Susan Preston-Martin; W James Gauderman; Elizabeth A Holly; Federico M Farin; Beth A Mueller; Roberta McKean-Cowdin Journal: PLoS One Date: 2013-11-18 Impact factor: 3.240