Increased incidence of childhood lymphoma in children with a history of small for gestational age at birth

Objective The aim of this study was to evaluate whether children that were born small for gestational age (SGA) have an increased risk for childhood neoplasm. Study design A population-based cohort analysis comparing the risk for long-term childhood neoplasms (benign and malignant) in children that were born SGA vs. those that were appropriate for gestational age (AGA), between the years1991–2014. Childhood neoplasms were predefined based on ICD-9 codes, as recorded in the hospital medical files. Kaplan–Meier survival curves were constructed to compare cumulative oncological morbidity in both groups over time. Cox proportional hazards model was used to control for confounders. Results During the study period 231,973 infants met the inclusion criteria; out of those 10,998 were born with a diagnosis of SGA. Children that were SGA at birth had higher incidence of lymphoma (OR 2.50, 95% CI 1.06–5.82; p value = 0.036). In addition, cumulative incidence over time of total childhood lymphoma was significantly higher in SGA children (Log Rank = 0.030). In a Cox regression model controlling for other perinatal confounders; SGA at birth remained independently associated with an increased risk for childhood lymphoma (adjusted HR 2.41, 95% CI 1.03–5.56, p value = 0.043). Conclusion Being delivered SGA is associated with an increased long-term risk for childhood malignancy and specifically lymphoma.