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@ARTICLE{Modugno:163650,
      author       = {F. Modugno and Z. Fu and S. J. Jordan and A. Group and J.
                      Chang-Claude$^*$ and R. T. Fortner$^*$ and M. T. Goodman and
                      K. B. Moysich and J. M. Schildkraut and A. Berchuck and E.
                      V. Bandera and B. Qin and R. Sutphen and J. R. McLaughlin
                      and U. Menon and S. J. Ramus and S. A. Gayther and A.
                      Gentry-Maharaj and C. Karpinskyj and C. L. Pearce and A. H.
                      Wu and H. A. Risch and P. M. Webb},
      title        = {{O}ffspring sex and risk of epithelial ovarian cancer: a
                      multinational pooled analysis of 12 case-control studies.},
      journal      = {European journal of epidemiology},
      volume       = {35},
      number       = {11},
      issn         = {1573-7284},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2020-01928},
      pages        = {1025-1042},
      year         = {2020},
      note         = {2020 Nov;35(11):1025-1042},
      abstract     = {While childbearing protects against risk of epithelial
                      ovarian cancer (EOC), few studies have explored the impact
                      on maternal EOC risk of sex of offspring, which may affect
                      the maternal environment during pregnancy. We performed a
                      pooled analysis among parous participants from 12
                      case-controls studies comprising 6872 EOC patients and 9101
                      controls. Odds ratios (ORs) and $95\%$ confidence intervals
                      (CIs) were calculated using multivariable logistic
                      regression for case-control associations and polytomous
                      logistic regression for histotype-specific associations, all
                      adjusted for potential confounders. In general, no
                      associations were found between offspring sex and EOC risk.
                      However, compared to bearing only female offspring, bearing
                      one or more male offspring was associated with increased
                      risk of mucinous EOC (OR = 1.45; $95\%$ CI = 1.01-2.07),
                      which appeared to be limited to women reporting menarche
                      before age 13 compared to later menarche (OR = 1.71 vs 0.99;
                      P-interaction = 0.02). Bearing increasing numbers of male
                      offspring was associated with greater risks of mucinous
                      tumors (OR = 1.31, 1.84, 2.31, for 1, 2 and 3 or more male
                      offspring, respectively; trend-p = 0.005). Stratifying by
                      hormonally-associated conditions suggested that compared to
                      bearing all female offspring, bearing a male offspring was
                      associated with lower risk of endometrioid cancer among
                      women with a history of adult acne, hirsutism, or polycystic
                      ovary syndrome (OR = 0.49, $95\%$ CI = 0.28-0.83) but with
                      higher risk among women without any of those conditions (OR
                      = 1.64 $95\%$ CI = 1.14-2.34; P-interaction = 0.003).
                      Offspring sex influences the childbearing-EOC risk
                      relationship for specific histotypes and conditions. These
                      findings support the differing etiologic origins of EOC
                      histotypes and highlight the importance of EOC
                      histotype-specific epidemiologic studies. These findings
                      also suggest the need to better understand how pregnancy
                      affects EOC risk.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32959149},
      doi          = {10.1007/s10654-020-00682-9},
      url          = {https://inrepo02.dkfz.de/record/163650},
}