Meta-analysis links perinatal factors to childhood acute leukemia riskPerinatal factors linked to higher leukemia risk in children

International journal of cancer Published May 1, 2026 Study authors: Blanco-Lopez Jessica, Kintossou Ambroise Kouame, Manohar Shiny, Iguacel Isabel, Pisanu Silvia, Almei… PubMed ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider that several perinatal factors are associated with modestly increased odds of childhood acute leukemia, but causality is not established.

This systematic review and meta-analysis of 85 studies evaluated associations between several perinatal factors and the risk of acute leukemia and its lymphoblastic subtype (ALL) in children or adolescents. The analysis pooled data from observational studies, providing a comprehensive overview of potential risk factors.

Key findings include increased odds of acute leukemia with high birth weight (>4000 g) (OR = 1.35, 95% CI 1.20-1.53), maternal history of abortion (OR = 1.27, 95% CI 1.12-1.43), and maternal diabetes (OR = 1.30, 95% CI 1.14-1.48). For ALL specifically, high birth weight (OR = 1.21, 95% CI 1.08-1.34), maternal history of abortion (OR = 1.24, 95% CI 1.08-1.43), maternal diabetes (OR = 1.32, 95% CI 1.16-1.50), maternal hypertension (OR = 1.21, 95% CI 1.06-1.38), and cesarean section (OR = 1.10, 95% CI 1.05-1.16) were associated with increased risk.

The authors note these findings are based on observational data, and causality cannot be inferred. Limitations such as potential confounding and heterogeneity across studies were not detailed in the provided data. The clinical relevance is framed as potential avenues for developing cost-effective prevention strategies at the population level, but individual risk prediction remains uncertain.

Clinicians should interpret these associations cautiously. While the results highlight possible risk factors, they do not establish causation and should not drive individual clinical decisions without further evidence.

This systematic review and meta-analysis examined 85 studies to look at how factors around birth might connect to the risk of acute leukemia and lymphoblastic leukemia in children or adolescents. The researchers analyzed data from a wide range of sources to see if specific perinatal factors were associated with these conditions.

The analysis found that high birth weight, defined as greater than 4000 grams, was linked to an increased risk of acute leukemia overall and specifically for the lymphoblastic subtype. Similarly, a maternal history of abortion, maternal diabetes, and maternal hypertension were all associated with higher risks. Cesarean section was also linked to a slightly increased risk of the lymphoblastic subtype.

Because this is a meta-analysis combining many studies, the results suggest these are associations rather than proof of direct cause and effect. The findings offer potential avenues for developing cost-effective prevention strategies applicable at the population level, but more research is needed to understand the exact mechanisms. Readers should view these results as links between factors and disease risk, not as evidence that these factors cause leukemia.

What this means for you:

This analysis links certain birth factors to higher childhood leukemia risk, suggesting new prevention strategies.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID41277016

View Original Abstract ↓

Acute leukemia is the most common type of cancer in children; however, the etiology is poorly understood. The objective of this review was to summarize the current evidence of the role of perinatal factors in the development of acute leukemia. All epidemiological studies published up to October 2023 that evaluated perinatal risk factors for childhood acute leukemia were identified using a multi-tiered approach in two electronic databases (PubMed and Web of Science), without restriction on publication year or language. A total of 85 studies (13 prospective cohort studies, 62 case-control studies, and 10 pooled analyses) were included. We combined the published risk estimates in a meta-analysis, using the Generic Inverse Variance method. An increased risk of acute leukemia and the lymphoblastic subtype (ALL) was associated with high birth weight (>4000 g) (odds ratio [OR] = 1.35; 95% confidence interval [95% CI] 1.20-1.53 and OR = 1.21; 95% CI 1.08-1.34, respectively), maternal history of abortion (OR = 1.27; 95% CI 1.12-1.43 and OR = 1.24; 95% CI 1.08-1.43, respectively), and maternal diabetes (OR = 1.30; 95% CI 1.14-1.48 and OR = 1.32; 95% CI 1.16-1.50, respectively). In addition, an increased risk for ALL was also associated with maternal hypertension (OR = 1.21; 95% CI 1.06-1.38) and cesarean section (OR = 1.10; 95% CI 1.05-1.16). Our review suggests a potential role for perinatal factors in the development of acute leukemia in children. These findings indicate potential avenues for developing cost-effective prevention strategies applicable at the population level, while the mechanism of action is investigated.

Meta-analysis links perinatal factors to childhood acute leukemia riskPerinatal factors linked to higher leukemia risk in children

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Meta-analysis links perinatal factors to childhood acute leukemia riskPerinatal factors linked to higher leukemia risk in children

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