Effects of hypertension and use of antihypertensive drugs in pregnancy on the risks of childhood cancers in Taiwan

Background: Childhood cancers are associated with high mortality and morbidity, and some maternal prescription drug use during pregnancy has been implicated in cancer risk. There are few studies on the effects of hypertension, preeclampsia, and the use of antihypertensives in pregnancy on children’s cancer risks. Objective: This population-based cohort study analyzed the relationship between hypertension, preeclampsia, and antihypertensives taken during pregnancy and the risks of childhood cancers in the offspring. Methods: Data on all children born in Taiwan between 2004 and 2015 (N = 2,294,292) were obtained from the Maternal and Child Health Database. This registry was linked with the National Health Insurance Database and Cancer Registry to get the records of maternal use of diuretics or other antihypertensives in pregnancy and records of children with cancer diagnosed before 13 years. We used Cox proportional hazard modeling to estimate the influence of maternal health conditions and antihypertensive drug exposure on the risks of developing childhood cancers. Results: Offspring of mothers with hypertension (chronic or gestational) had a higher risk of acute lymphocytic lymphoma [hazard ratio (HR) = 1.87, 95% Confidence Interval (CI) 1.32 – 2.65] and non-Hodgkin’s lymphoma (HR = 1.96, 95% CI 1.34 – 2.86). We estimated only a weak increased cancer risk in children whose mothers used diuretics (HR = 1.16, 95% CI 0.77 – 1.74) or used antihypertensives other than diuretics (HR = 1.15, 95% CI 0.86 – 1.54) before birth. Conclusions: In this cohort study, children whose mothers had chronic and gestational hypertension had an increased risk of developing childhood cancer.