BMJ 1998;316:173-177 (17 January)

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Case-control study of childhood leukaemia and cancer in Scotland: findings for neonatal intramuscular vitamin K

Patricia A McKinney, principal researcher,a Edmund Juszczak, senior statistician,a Elizabeth Findlay, research nurse,a Katrina Smith, senior administrator a

a Information and Statistics Division, Common Services Agency for the National Health Service in Scotland, Trinity Park House, Edinburgh EH5 3SQ

Correspondence to: Dr McKinney p.a.mckinney@leeds.ac.uk

Objective: To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers.
Design: Population based case-control study with data abstracted from hospital records.
Setting: Scotland.
Subjects: Children aged 0-14 years resident in Scotland from 1991-4 and diagnosed with leukaemia (150), lymphomas (46), central nervous system tumours (79), a range of other solid tumours (142), and a subset of acute lymphoblastic leukaemia (129). Controls were 777 children matched for age and sex, providing 417 matched sets (360 triplets and 57 pairs) for analysis.
Main outcome measure: Odds ratios for the risk of childhood leukaemia and cancer and intramuscular vitamin K versus a combined group of oral doses, none, and no record. Results are given for information recorded in medical notes and data supplemented by hospital policy.
Results: Odds ratios based on medical record abstractions showed no significant positive association for leukaemias (odds ratio 1.30; 95% confidence interval 0.83 to 2.03), acute lymphoblastic leukaemia (1.21; 0.74 to 1.97), lymphomas (1.06; 0.46 to 2.42), central nervous system tumours (0.74; 0.40 to 1.34), and other solid tumours (0.59; 0.37 to 0.96). There was no association with acute lymphoblastic leukaemia in children aged 1 to 6 years. Imputation of exposure from hospital policy gave similar results. Adjustment for deprivation and type of delivery moved risk estimates closer to unity for all major diagnostic groups.
Conclusions: The observation of an increased risk of childhood leukaemia and cancer associated with intramuscular vitamin K is not confirmed by this independent population based study.

Key messages

  • Debate continues over the role neonatal intramuscular administration of vitamin K may have in the subsequent development of childhood cancer

  • Most previous epidemiological studies have failed to demonstrate an overall significant association

  • No significant risk is evident from a population based study in Scottish children that used data from hospital records

  • No relation was found for leukaemias, central nervous system tumours, or any other subgroup of childhood malignancy


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