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Study Title and Description

Maternal alcohol and coffee drinking, parental smoking and childhood leukaemia: a French population-based case-control study.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on reproductive and developmental outcomes?
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Primary Publication Information
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TitleData
Title Maternal alcohol and coffee drinking, parental smoking and childhood leukaemia: a French population-based case-control study.
Author F Menegaux,M Ripert,D Hémon,J Clavel,
Country
Year 2007
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Reproductive Toxicity - Design Details
Arms
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Design Details
Question... Follow Up Answer Follow-up Answer
Refid 17564585
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What outcome is being evaluated in this paper? Reproductive and Development
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What is the objective of the study (as reported by the authors)? We investigated the role of maternal alcohol and coffee drinking during pregnancy and that of parental smoking in the etiology of childhood leukemia.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) A French, population-based, case–control study was conducted, comparing 472 [407 acute lymphoblastic leukemia (ALL) and 62 acute myeloblastic leukemia] cases of childhood acute leukemia (AL) and 567 population controls, frequency-matched with cases on age, gender and region of residence. The cases were derived from the National Registry of Childhood Blood Malignancies (NRCL). The mothers completed a standardized self-administered questionnaire that was distributed by the physician for the cases and sent by mail to the controls.\ the number of cups of coffee per day (without any distinction between instant/ground or regular/ decaffeinated). Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals [CI]. All analyses were adjusted for the stratification variables. Sociodemographic factors such as the mother’s educational level, place of residence at diagnosis and other factors that had previously been shown to be related to childhood leukemia in the present study were also included as potential confounders.
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) childhood leukemia: acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia, and acute leukemia (AL)
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes
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Clinical Clinical
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Physiological
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Other
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What is the study design? Case-Control
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Both
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Optional: Name of Method or short description The cases were derived from the National Registry of Childhood Blood Malignancies (NRCL). In order for cases to be eligible, AL was to have been newly diagnosed in subjects aged <15 years .
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Caffeine (general)
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Coffee Coffee
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Chocolate
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Energy drinks
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Gum
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Medicine/Supplement
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Soda
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Tea
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Measured
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Self-report Self-report
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Children
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Adolescents
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Adults
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Pregnant Women Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) coffee: </= 3 or >3 cups/day
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) Odds ratios adjusted for age, gender, region, socio-professional category and birth order. Sociodemographic factors such as the mother’s educational level, place of residence at diagnosis and other factors that had previously been shown to be related to childhood leukemia in the present study were also included as potential confounders.
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Provide a general description of results (as reported by the authors). While maternal coffee consumption was not significantly related to AL (OR = 1.4 [95% CI 0.9, 2.3]), highest intake of coffee (more than 3 cups per day) during pregnancy was associated with AL in children whose mothers were non-smokers (OR = 1.9 [95% CI 1.0, 3.5]). Interestingly, the association with maternal coffee consumption of _3 cups per day during pregnancy was different for smokers (OR = 0.9 [95% CI 0.3, 2.4]) than for non-smokers (OR = 1.9 [95% CI 1.0, 3.5]). However, the interaction between maternal coffee drinking and maternal smoking during pregnancy was not significant. REVIEWER NOTE: The data on smoking were not presented.
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? While maternal coffee consumption was not significantly related to AL (OR = 1.4 [95% CI 0.9, 2.3]), highest intake of coffee (more than 3 cups per day) during pregnancy was associated with AL in children whose mothers were non-smokers (OR = 1.9 [95% CI 1.0, 3.5]).
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What were the sources of funding? This work was supported by grants from INSERM, the Ministère de l’Environnement et de l’Aménagement du Territoire, the Fondation pour la Recherche Médicale, the Association pour la Recherche contre le Cancer, the Fondation de France, and the Institut Electicité Santé.
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What conflicts of interest were reported? None reported
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Does the exposure (dose) need to be standardized to the SR? Yes
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest). 3 cups/day x 95 mg/cup = 285 mg/day
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  NOAEL for all childhood acute leukemia = >285 mg/day
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. OR = 1.4 [95% CI 0.9, 2.3] for AL at >3 cups/day; no significant ORs at either dose level and in any subgroup
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What is the importance of the study with respect to the adverseness of the outcome? Critcal
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