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Pediatric Cancer — Causes & Risk Factors
Pregnancy & in-utero exposures — and childhood cancer risk
Medically reviewed by Dr. Naresh Gundu, Medical Oncologist · Last reviewed June 2026
If your child has been diagnosed with cancer, one of the first questions you may be asking is: did something during my pregnancy cause this? It is one of the most painful questions a parent can carry. This page explains what the medical evidence actually shows — clearly and compassionately — so you can stop searching and start understanding.
- Most cases have no identifiable pregnancy cause — childhood cancer typically arises from spontaneous cell changes
- Radiation in pregnancy — only high therapeutic doses carry documented risk; diagnostic scans do not
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Understanding the evidence
What does pregnancy and childhood cancer research actually tell us?
The relationship between pregnancy and childhood cancer is one of the most intensely studied questions in paediatric oncology — because it is the question parents need answered most urgently. After decades of research across hundreds of thousands of families worldwide, the evidence points clearly in one direction: in the large majority of childhood cancer cases, nothing that happened during pregnancy caused the cancer.
Childhood cancers typically begin when the DNA inside a single developing cell is altered in a way that removes the normal brakes on cell growth. These alterations — called mutations — can happen during the extraordinarily rapid cell division of foetal development, and they are mostly random. They are the biological equivalent of a copying error when a document is reproduced millions of times at high speed. No lifestyle choice, no food, no level of stress, and no ordinary environmental contact causes those random copying errors.
A small number of in-utero exposures have been studied carefully and do show a measurable association with childhood cancer risk. These are specific, high-level exposures — not the everyday concerns that most parents are searching about when they ask whether pregnancy caused their child's cancer. We cover the evidence for each of the main investigated exposures in the section below.
If your child has been diagnosed and you are reading this page looking for something to blame, we want to say something clearly before you go further: the guilt you are carrying is one of the most common responses to a childhood cancer diagnosis, and it is not medically warranted in the overwhelming majority of cases. Our consultations are 45 minutes long — long enough for you to ask every question you have been holding.
What parents ask about most
Pregnancy exposures — what does the evidence actually show?
Below are the exposures most commonly asked about by parents after a childhood cancer diagnosis. For each, we summarise what the published medical evidence says — clearly, without minimising or overstating.
Strongest evidence
High-dose ionising radiation to the abdomen
Therapeutic radiation — the kind used to treat cancer in a pregnant mother, directed at or close to the uterus — is the most clearly documented prenatal cancer risk. This is not the same as diagnostic X-rays. Modern diagnostic doses are vastly lower. If you or your child received radiation therapy during pregnancy, discuss the specific circumstances with your oncologist.
Diagnostic imaging: very low risk
Radiation in pregnancy: X-rays, CT scans, and airport scanners
Routine diagnostic X-rays, dental X-rays, and airport security scanners deliver radiation doses many thousands of times below the therapeutic thresholds studied. Major guidelines from the ACOG and ICRP indicate that a single diagnostic X-ray during pregnancy does not meaningfully increase childhood cancer risk. A CT scan of the abdomen delivers more dose and should be justified clinically but remains within accepted safety margins when medically necessary.
Some studies: modest association
Pesticide exposure during pregnancy
Several epidemiological studies have found an association between prenatal exposure to certain pesticides — particularly organophosphate insecticides used in agriculture — and a modestly elevated risk of childhood leukemia and brain tumours. IARC classifies some organophosphates as probably or possibly carcinogenic. These are population-level associations; they do not mean any individual child's cancer was caused by a specific pesticide contact.
Evidence: weak or inconsistent
Tobacco smoke during pregnancy
Some studies have found a weak association between heavy maternal tobacco exposure during pregnancy and slightly elevated risk of certain childhood cancers, particularly brain tumours and leukemia. The evidence is not consistent across all studies, and the size of any association — where it exists — is small. Tobacco has many well-documented harms in pregnancy beyond cancer risk, but it is not established as a primary cause of childhood cancer.
No established link
Alcohol, caffeine, and common medications
Maternal alcohol consumption during pregnancy is not established as a direct cause of childhood cancer, though it causes other serious harms (foetal alcohol spectrum disorder). Caffeine in moderate quantities and most common medications taken under medical supervision — including paracetamol — have not been shown to increase childhood cancer risk in well-designed studies. If you took a specific medication during pregnancy and are worried, your oncologist can review the evidence for that drug.
No established link
Diet, stress, and electronic devices
There is no credible scientific evidence that maternal diet (beyond extreme nutritional deficiency), psychological stress, mobile phone use, Wi-Fi, or microwave ovens during pregnancy cause childhood cancer. These concerns are very commonly searched but are not supported by the body of published paediatric oncology research. Some observational studies of diet have found associations in specific nutrients, but these are preliminary and not actionable as individual risk factors.
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What to do next
If you are worried about a specific in-utero exposure — here is a clear path forward
You have a specific concern about something that happened during your pregnancy. Here is how to think through it, and how to get an expert answer you can trust.
Write down what you remember — specifically
The most useful information for an oncologist or genetic counsellor is specific: What was the exposure? During which trimester? How heavy or prolonged was it? Was it a one-time event (such as a single X-ray) or ongoing (such as working in an environment with chemical exposure)? Write these details down before your consultation so that the conversation can be focused and productive. A single diagnostic X-ray in the first trimester is a very different question from months of heavy occupational pesticide exposure in a field — and both deserve a specific answer, not a generic one.
Bring the information to your child's oncologist
Your child's oncologist is the right first point of contact for this question. They know your child's specific diagnosis — the cancer type, age at diagnosis, and any other clinical features — which is the context that makes the question of prenatal exposure answerable. Some cancer types have no known prenatal risk factors at all; others may have associations that are worth discussing further. The oncologist will tell you whether your specific concern is worth investigating further, or whether the evidence clearly does not apply to your child's situation.
Ask whether genetic counselling is appropriate
For some families — particularly those where the cancer type, the child's age at diagnosis, or a pattern of cancer in the family raises a question about inherited risk — a referral to a genetic counsellor is the most informative next step. A genetic counsellor is a specialist who evaluates whether an identifiable hereditary factor may be present and what it means for the whole family. This is separate from the question of prenatal exposure, but the two questions are often asked together and a counsellor can address both in a single session.
Recognise when the question matters — and when it does not change treatment
Understanding the possible cause of your child's cancer is a valid and important question. However, in most cases — even when a probable risk factor is identified — it does not change the treatment plan. The cancer is treated based on its type, stage, and biology, not based on what may have contributed to it. Knowing the cause may be important for future family planning decisions or for monitoring siblings, but it is rarely urgent from the perspective of your child's immediate care. The oncology team at CION will help you separate what needs to be addressed now from what can be explored in parallel.
Let the treatment team focus on what is ahead — not just what is behind
The question of causation is understandable and worth exploring. But cancer treatment is forward-facing. The most powerful thing you can do for your child right now is to ensure they receive a personalised, evidence-based treatment plan reviewed by a team — not a single doctor's opinion. At CION, every paediatric case is reviewed by a tumor board of 17 oncologists. We walk this journey with you — from the first question about what caused this, through every step of treatment and recovery.
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Common questions
Pregnancy and childhood cancer — answers to what parents ask most
Can something I did during pregnancy cause childhood cancer?
In the vast majority of cases, no. Most childhood cancers arise from random errors in cell division during the child's own development — errors that are not caused by anything a mother did, ate, took, or was exposed to during pregnancy. A small number of environmental factors — principally high-dose ionising radiation to the abdomen during pregnancy — have a documented association with childhood cancer risk. However, the exposures most parents worry about (routine diagnostic X-rays, airport scanners, common medications, diet, stress) are not established causes of childhood cancer. If you are carrying this question, please bring it to your consultation. You deserve a clear, evidence-based answer — not an internet search at midnight.
Is radiation in pregnancy linked to childhood cancer?
High-dose ionising radiation — the kind used in radiation therapy, not diagnostic imaging — directed at or near the pregnant abdomen is an established risk factor for childhood cancer. This association was first documented in large studies of children whose mothers received therapeutic abdominal radiation and has been confirmed in subsequent research. In contrast, modern diagnostic X-rays (chest X-ray, dental X-ray) and airport security scanners deliver doses many thousands of times lower than therapeutic radiation and are not associated with a meaningful increase in childhood cancer risk. If you or your child received any radiation exposure during pregnancy, discuss the specific dose and type with your oncologist — context matters enormously.
Does pesticide exposure during pregnancy increase the risk of childhood cancer?
Some observational studies have found associations between prenatal pesticide exposure — particularly certain organophosphate insecticides — and a modestly elevated risk of childhood leukemia and brain tumours. The International Agency for Research on Cancer (IARC) has classified some pesticides as probable or possible carcinogens. However, these are population-level associations from epidemiological studies, not evidence that any individual child's cancer was caused by a specific pesticide exposure. If you worked in agriculture, lived near fields with heavy pesticide use, or had significant domestic pesticide exposure during pregnancy and your child has been diagnosed with cancer, this is a relevant detail to share with your oncologist.
What in-utero exposures are linked to childhood cancer?
The in-utero exposures most consistently linked to childhood cancer risk in published research are: high-dose ionising radiation to the maternal abdomen (strongest evidence); certain chemotherapy agents given during pregnancy (rare, but documented); and, with weaker evidence, heavy tobacco smoke exposure and some occupational chemical exposures. The association between maternal alcohol consumption and childhood cancer is not conclusively established, though alcohol has many other well-documented harms in pregnancy. Most prenatal exposures parents worry about — common medications taken under medical supervision, coffee in moderate quantities, mobile phone use, Wi-Fi — have not been shown to increase childhood cancer risk in well-designed studies.
My child was diagnosed with cancer — should I be tested for anything?
Whether any testing of parents or siblings is indicated depends on the type of cancer your child has been diagnosed with, the child's age at diagnosis, and whether there is a pattern of cancer in the family. For most childhood cancers, parental testing is not necessary because the cancer arose from changes in the child's own cells. However, for a small number of cancers associated with inherited gene changes — such as hereditary retinoblastoma (RB1 gene) or Li-Fraumeni syndrome (TP53 gene) — parental genetic testing can give important information for the whole family. Your child's oncologist or a genetic counsellor is the right person to advise you on whether any testing is warranted in your specific situation.
How does CION approach childhood cancer when parents have questions about pregnancy and cause?
At CION, every paediatric cancer case is reviewed by a tumor board — a team of specialists who look at the full picture together, not just one doctor's opinion. Our consultations are 45 minutes, which means there is real time to talk through questions parents carry — including questions about pregnancy, exposures, genetics, and cause. We do not give rushed answers or dismiss parental concerns. If genetic counselling or specialist evaluation is warranted, we will coordinate that referral. We walk this journey with you, from the first question to the last day of follow-up.
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