Date of Award

January 2024

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Xiaomei Ma

Second Advisor

Rong Wang

Abstract

Purpose: This study aimed to evaluate the risk of pediatric glioma in relation to multiple birth and parental characteristics as well as environmental exposures, in the overall California population and in racial and ethnic subgroups.

Methods: Leveraging a population-based linkage of statewide birth records and cancer registry data in California, we conducted a case-control study that included 3,244 cases who were born in California during 1982-2015 and diagnosed with first primary glioma at the age of 0-19 years during 1988-2015, and 162,200 controls who were born in California and frequency-matched to cases on year of birth. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models, in the overall study population, and non-Hispanic White (NHW) and Hispanic subgroups, respectively.

Results: In the overall study population, NHW, and Hispanic subgroups, every 500g increase in birth weight was associated with an approximately 7% increase in glioma risk, and children whose mother’s insurance was not private had an about 20% decreased risk of glioma compared to children whose mother had private insurance. Among NHW children, maternal age of ≥35 years at delivery was associated with a higher risk of glioma compared to maternal age of 25-29 years (OR = 1.26, 95% CI: 1.07-1.48). Children whose exposure to outdoor artificial light at night (ALAN) was in the third quartile had a lower glioma risk compared to those whose outdoor ALAN exposure was in the first quartile (OR = 0.84, 95% CI: 0.72-0.99). Among Hispanic children, maternal education less than high school was associated with a lower risk of glioma compared to the maternal education level of high school (OR = 0.83, 95% CI: .71-0.97). Children whose mother was born outside the United States or had a history of cesarean deliveries also had lower odds of developing glioma. In addition, children who were born in a month with a higher level of ambient fine particulate matter (PM2.5) had an increased risk of glioma (fourth quartile compared with first quartile: OR = 1.28, 95% CI: 1.02-1.60).

Conclusion: In this large, population-based case-control study of pediatric glioma, a few risk factors observed for NHW and Hispanic children exhibited different patterns, underscoring the need to further evaluate racial and ethnic disparities in disease etiology and identify possible underlying mechanisms.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/07/2026

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