Birth Outcomes Among Adolescent and Young Adult Cancer Survivors

Anderson, Chelsea; Engel, Stephanie M.; Mersereau, Jennifer E.; Black, Kristin Z.; Wood, William A.; Anders, Carey K.; Nichols, Hazel B.

doi:10.1001/jamaoncol.2017.0029

Cited by 70 publications

(114 citation statements)

References 23 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…As in previous studies, we found survivors to have a significantly increased risk for preterm delivery compared to comparison subjects. We also found a 45% higher risk for overall hospitalization among survivors compared to population comparisons but could not identify any specific reasons for the increased risk for hospitalization as most survivors belonged to the category hospitalization for other reasons than vaginal bleeding, pre‐eclampsia or threatened preterm labor.…”

Section: Discussionsupporting

confidence: 87%

“…Various explanations for this elevated risk have been offered. Abdomino‐pelvic irradiation and chemotherapy have been identified as risk factors for preterm delivery and low birth weight of the fetus . In these survivors, the cancer treatment could lead to impaired uterine growth and reduced blood flow, resulting in uterine fibrosis and cervical shortening.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for preterm delivery among early onset cancer survivors: A Finnish register‐based study

Melin

Heinävaara

Malila

et al. 2018

Intl Journal of Cancer

View full text Add to dashboard Cite

Previous studies have shown an elevated risk for preterm delivery among early onset cancer survivors. Whether the preterm delivery starts spontaneously, due to possible uterine damage because of cancer treatment, or is induced due to maternal conditions is unclear. Our aim was to assess pregnancy related conditions in female cancer survivors possibly underlying the elevated risk for preterm labor. Nationwide cancer and birth registries were merged to identify 1,753 first deliveries of cancer survivors (diagnosed below 40 years of age) and 5,123 first deliveries of matched female comparison subjects between January 1991 and December 2013. Conditional logistic regression models were used to estimate the risk for pregnancy related conditions adjusting for maternal age, gestational age and smoking. We found an overall increased risk for hospitalization during pregnancy (OR 1.45, 95% CI 1.25–1.68), intrahepatic cholestasis (OR 2.86, 95% CI 1.09–7.49), fear of childbirth (OR 2.25, 95% CI 1.31–3.85) and mental disorders and diseases of the nervous system complicating pregnancy and labor (OR 5.89, 95% CI 2.31–15.00). Among survivors, 129 (7.4%) delivered preterm compared to 268 (5.2%) comparisons subjects (p = 0.004). We found a statistically significant increased risk for preterm delivery among cancer survivors with vaginal bleeding (OR 1.35, 95% CI 1.07–1.71) and pre‐eclampsia (1.35, 95% CI 1.06–1.72) compared to comparison subjects with the same condition. Health professionals treating these women should be aware of these risks. In general, however, our results are reassuring when it comes to pregnancies among cancer survivors.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Risk factors for preterm delivery among early onset cancer survivors: A Finnish register‐based study

Melin

Heinävaara

Malila

et al. 2018

Intl Journal of Cancer

View full text Add to dashboard Cite

show abstract

“…Previous U.S.‐based studies have suggested that low birth weight and preterm deliveries are more common among breast cancer survivors relative to the general population . However, among women who conceive after diagnosis, the magnitude of these associations appears to be modest.…”

Section: Discussionmentioning

confidence: 92%

“…Recent studies from Canada and Europe have documented a decreased incidence of childbirth among breast cancer survivors relative to age‐matched women in the general population. Other reports suggest that those who do give birth after breast cancer may have an increased risk of low birth weight and preterm deliveries compared to women without cancer . However, variation in these outcomes according to factors such as hormone receptor status and endocrine therapy use has not been previously explored.…”

Section: Introductionmentioning

confidence: 99%

Live birth outcomes after adolescent and young adult breast cancer

Anderson

Engel

Anders

et al. 2018

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

Reproductive outcomes are an important survivorship concern for women diagnosed with cancer as adolescents and young adults (AYAs). We examined the incidence of live birth and the prevalence of adverse birth outcomes according to tumor and treatment characteristics among AYAs with breast cancer. Women diagnosed with breast cancer at ages 15-39 during 2000-2013 were identified using the North Carolina Central Cancer Registry (n = 4,978). Cancer registry records were linked to state birth certificate files from 2000 to 2014 to identify births to women with and without a breast cancer history. The breast cancer cohort was followed until live birth, death, age 46, or December 31, 2014, whichever occurred first. For each birth to breast cancer survivors (n = 338), we sampled 20 births to women without a recorded cancer diagnosis, with frequency matching on maternal age and year of delivery. The cumulative incidence of live births after breast cancer was 8% at 10 years. Births were less common among women treated with chemotherapy. Overall, the prevalence of preterm birth, low birth weight, small-for-gestational age (SGA) and Cesarean delivery did not differ substantially between births to women with and without breast cancer. However, births to women with ER-negative disease were more likely to be preterm (PR = 1.84; 95% CI: 1.11-3.06). In this population-based study, <10% of AYA breast cancer survivors had a live birth within 10 years of their diagnosis. The increase in risk of preterm delivery among ER-negative survivors in our cohort warrants further investigation in larger studies.

show abstract

“…29 Some studies have reported associations between stress during pregnancy and preterm delivery, 30 low delivery weight, 31 When stratifying by publication year, the association between breast cancer history and the risks of preterm delivery and low delivery weight appeared to be slightly stronger in studies published before 2010 compared with those published after 2010. 29 Some studies have reported associations between stress during pregnancy and preterm delivery, 30 low delivery weight, 31 When stratifying by publication year, the association between breast cancer history and the risks of preterm delivery and low delivery weight appeared to be slightly stronger in studies published before 2010 compared with those published after 2010.…”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis of associations between maternal breast cancer and the risk of adverse delivery outcomes

Sun

Yang

2017

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

Birth Outcomes Among Adolescent and Young Adult Cancer Survivors

Abstract: Live births to AYA cancer survivors may have an increased risk of preterm birth and low birth weight, suggesting that additional surveillance of pregnancies in this population is warranted. Our findings may inform the reproductive counseling of female AYA cancer survivors.

Cited by 70 publications

References 23 publications

Risk factors for preterm delivery among early onset cancer survivors: A Finnish register‐based study

Risk factors for preterm delivery among early onset cancer survivors: A Finnish register‐based study

Live birth outcomes after adolescent and young adult breast cancer

Meta‐analysis of associations between maternal breast cancer and the risk of adverse delivery outcomes

Contact Info

Product

Resources

About