Maternal Quality of Life During Pregnancy and Early Childhood Cancer: A Mixed-Methods Case-Control Study

Abstract

Introduction: This study investigates the relationship between maternal quality of life during pregnancy and childhood cancer risk, hypothesizing that lower maternal well-being increases the likelihood of cancer development in children. Methods: This embedded explanatory sequential mixed-methods case-control study was conducted in Kerman, Iran, including 191 children under six, with 136 diagnosed with cancer in 2023. From these, 73 mothers of affected children were purposefully selected and compared to 118 mothers of healthy children, matched by age and socioeconomic status. Maternal factors (e.g., age, education, employment, medical history, and lifestyle) were assessed using validated questionnaires (GHQ-28, SES), administered through structured interviews. Logistic regression (SPSS 28) and Python-based heatmap visualization were used for analysis. Qualitative data were extracted from interview narratives and analyzed thematically. Results: Between 2014 and 2023, pediatric cancer diagnoses increased, especially malignant types. Significant maternal factors included older age, unemployment, lower education, medical history, and smoking. Paternal education, occupational exposure, and smoking also contributed. Qualitative themes—persistent anxiety, depressive thoughts, and perceived lack of purpose—offered contextual depth to the statistical findings. Conclusions: Maternal quality of life during pregnancy significantly influences childhood cancer risk. Integrated interventions addressing maternal mental health, socioeconomic disparities, and occupational exposures are essential. Public health policies should prioritize maternal well-being to create protective environments for children.