Effects of cancer treatment during pregnancy on fetal and child development

Abstract

It has become clear that, for specific cancers and under well defined circumstances, oncological treatment in pregnancy is possible. In this Review, we summarise the evidence on fetal, neonatal, short-term, and long-term effects of prenatal exposure to cancer treatment on the child. So far, outcomes of children are generally reassuring, but long-term follow-up is insufficient. The most important risks of chemotherapy during pregnancy are preterm birth and babies being small for gestational age. Chemotherapy in the first trimester is contraindicated because of an increased risk of congenital malformations. Studies on outcomes of children exposed to radiotherapy, targeted therapy, or hormonal therapy in pregnancy are scarce. Careful registration of women undergoing cancer treatment in pregnancy and long-term follow-up of their children are important. Comprehensive documentation of the mental and physical status of children exposed to cancer treatment in utero will allow physicians and parents to best decide whether to treat cancer during pregnancy.

Arsenic Trioxide Treatment during Pregnancy for Acute Promyelocytic Leukemia in a 22-Year-Old Woman

“…Cancers during pregnancy represent clinical and ethical dilemmas for medical teams. So far, evidences on pediatric outcomes after most of maternal cancer's treatment during pregnancy are reassuring [5]. APL is an oncologic emergency known to increase the risk of abortion, perinatal mortality, preterm delivery, and intrauterine growth restriction during pregnancy [6].…”

The role of imaging techniques in the diagnosis, staging and choice of therapeutic conduct in pregnancy associated breast cancer

“…These risks after in-utero exposure to chemotherapy during late pregnancy are reduced to: low birthweight, subtle changes to heart function due to cardiomyopathy caused by anthracyclines [33,34], respiratory distress syndrome [35], fetal anemia [35], bilateral reduction of hearing and mild ventriculomegaly [35,36]. Also, during childhood there may be dental problems, because tooth formation is completed only postnatally, and infants can be more susceptible to dental malformations and dental caries [36]. Neurocognitive problems during childhood such as disturbances in intelligence, memory and attention deficits and language impairment [36] were also described but there is a lack of evidence to support such an association.…”

“…Also, during childhood there may be dental problems, because tooth formation is completed only postnatally, and infants can be more susceptible to dental malformations and dental caries [36]. Neurocognitive problems during childhood such as disturbances in intelligence, memory and attention deficits and language impairment [36] were also described but there is a lack of evidence to support such an association.…”

The Safety of Viscum Album L. in A Murine Model: A Reproductive Toxicity Study

“…The incidence of pregnancy-associated breast cancer is increasing as women are delaying childbirth until later [1,[4][5][6]. Recent data shows incidence of breast cancer during pregnancy as 1 in 3,000 to 10,000 birth deliveries, positioning these diagnosis as common as cervical uterine cancer [1,3,[7][8][9]. Chemotherapy remains the cornerstone treatment for cancer.…”