Date of Award

January 2016

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Xiaomei Ma



Objective: To evaluate the relationship between birth weight and the risk of pediatric Hodgkin lymphoma (HL, age at diagnosis: 0-19 years).

Method: We linked California statewide birth records from 1978-2009 and cancer diagnosis data from 1988-2011 to conduct a population-based case-control study with 1,216 cases and 4,485 controls (matched on birth month and year, sex, and race/ethnicity). Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) of pediatric HL overall and by age of diagnosis, controlling for other perinatal factors.

Results: Compared to children with a normal birth weight (2500-3999 g), those who had a high birth weight (≥ 4000 g) had a significantly increased risk of pediatric HL overall (OR=1.23, 95% CI: 1.02-1.48). The magnitude of association was larger for subgroups of children whose age of diagnosis was 0-10 years (OR=1.56, 95% CI: 1.04-2.24) or 15-19 years (OR=1.43, 95% CI: 1.11-1.83), while no association was observed in 11-14 year olds. Compared to firstborn children, those who were third or higher in birth order had a significantly reduced risk of pediatric HL overall (OR=0.80, 95% CI: 0.67-0.95), and this association also varied by age of diagnosis.

Conclusions: In this study with the largest number of pediatric HL cases, high birth weight was associated with an increased disease risk. The different findings by age of diagnosis regarding both birth weight and birth order underscore the importance to stratify pediatric HL by age at diagnosis in future etiological investigations.


This is an Open Access Thesis.

Open Access

This Article is Open Access