Researchers at Departments of Neurology, Pediatrics and Neurosurgery, Stanford University, CA linked 3733 patients aged 0 to 14 years with CNS tumors listed in the California Registry to a California birth certificate. Odds ratios for reported birth defect and history of pregnancy losses were calculated using logistic regression and adjusted for race, maternal age, birth weight, and birth order. Mothers with – or >2 fetal losses after 20 weeks’ gestation had a 3-fold risk of offspring with CNS tumors and a 14-fold risk of high-grade glioma. Children with congenital birth defects had an increased risk of the CNS cancers medulloblastoma, primitive neuroectodermal tumor and germ cell tumors, tumors that tend to arise in the midline. Among tumor types in case patients, gliomas were most frequent (57%): 1380 cases were low-grade gliomas and 757 were high-grade. Embryonal (889 [24%]) and ependymoma (292 [8%]) were less frequent. Choroid plexus tumors (2%) and craniopharyngiomas (0.5%) were rare. Previous pregnancy losses and birth defects may be surrogate markers for gene defects in developmental pathways that lead to CNS tumorigenesis. [1]

COMMENT. In this population-based case-control study, mothers who have already lost –or>2 fetuses after 20 weeks’ gestation have a significant risk of CNS tumors in their offspring, and children with birth defects are also at increased risk, especially of midline CNS tumors.