Maternal Diabetes and Childhood Cancer Risks in Offspring: A Nationwide Cohort Study
A nationwide Korean cohort study analyzed over half a million births to assess the link between maternal diabetes and childhood cancer, finding no overall increase in risk but a specific elevation in urinary tract cancer
Maternal diabetes is associated with several adverse childhood outcomes, but its link to childhood cancer remains inconclusive. We investigated this in a nationwide birth cohort using the Korean National Health Insurance database. The study analyzed women who delivered singletons between January 2003 and December 2004, and followed their offspring to December 2021. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for maternal and neonatal factors.
Among 549,851 women, 33,041 (6.0%) had a diabetic pregnancy. During follow-up, childhood cancer developed in 6,049 (1.1%) offspring. No difference was observed in overall risk of cancer incidence between offspring of mothers with or without diabetes (adjusted HR: 1.09, 95% CI 0.99–1.21). However, site-specific analyses revealed an increased relative risk of urinary tract cancer in offspring exposed to maternal diabetes (adjusted HR: 1.81, 95% CI 1.23–2.66).
Notably, the absolute risk of urinary tract cancer remained extremely low across the cohort, with an absolute risk difference of only 0.04%. This finding suggests that while there is a statistically significant relative increase in specific cancer types, the actual probability remains negligible for the general population.
In conclusion, while maternal diabetes is associated with an increased relative risk of childhood urinary tract cancer, the absolute risk is remarkably low, providing clinical reassurance to mothers with diabetes. Researchers emphasize that these findings should be interpreted within the context of overall public health data and do not imply a causal relationship for all pediatric cancers.