Female Survivors of Childhood Cancer: Preterm Birth and Low Birth Weight Among Their Children

Signorello, Lisa B.; Cohen, Sarah S.; Bosetti, Cristina; Stovall, Marilyn; Kasper, Catherine E.; Weathers, Rita; Whitton, John; Green, Daniel M.; Donaldson, Sarah S.; Mertens, Ann C.; Robison, Leslie L.; Boice, John D.

doi:10.1093/jnci/djj394

Cited by 258 publications

(253 citation statements)

References 34 publications

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“…Recently, a large cohort study of female survivors of childhood cancer found that 19.2% of 337 women with childhood HD had a preterm birth compared with 12.6% among sibling controls (Signorello et al, 2006). Another study reported 11 stillbirths among 729 births of female survivors of childhood HD, corresponding to a relative risk of 1.6 (95% CI: 0.64-4.03) (Green et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Hodgkin's disease and birth outcome: a Danish nationwide cohort study

et al. 2007

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In a Danish nationwide cohort study of 292 births from 1973 to 2002 in women with Hodgkin's disease (HD), we compared birth outcome with 14 042 births from a cohort of mothers without cancer. We found no substantially increased risk of preterm birth, low birth weight at term, or stillbirth and no difference in proportion of male newborns for 192 children of women with HD before pregnancy. The prevalence odds ratio (POR) for congenital abnormalities was 1.7 (95% confidence interval (CI): 0.9 -3.1). Among 15 newborns of mothers diagnosed during pregnancy, the POR of preterm birth was 26.6 (95% CI: 8.5 -83.0), but five out of the eight preterm deliveries among these women were elective. We found no substantially increased risk of adverse birth outcome among 85 newborns of women diagnosed within 2 years postpartum, though effect estimates were imprecise. The overall findings are reassuring, they cannot exclude the possibility of an increased risk of congenital abnormalities for newborns of women diagnosed with HD before pregnancy.

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Section: Discussionmentioning

confidence: 99%

Hodgkin's disease and birth outcome: a Danish nationwide cohort study

et al. 2007

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“…The CCSS examined pregnancy outcomes in both male and female survivors in comparison with their sibling cohort. 39,40 The offspring of female survivors were more likely to be born before 37 4.0 [95% CI, 1.6-9.8], P ¼ .003). The frequency of premature birth was not found to be increased by previous maternal exposure to increasing doses of chemotherapy with alkylating agents.…”

Section: The Effect Of Radiotherapy On Testicular Functionmentioning

confidence: 99%

Oncofertility and preservation of reproductive capacity in children and young adults

Wallace

2011

Cancer

170

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With increasing numbers of survivors from cancer at a young age, the issue of fertility preservation has assumed greater importance. This review describes normal ovarian and testicular function and summarizes what is known about the effect of chemotherapy and radiotherapy on the gonads and uterus. All young patients with cancer or leukemia should have their fertility prognosis discussed before the initiation of treatment. Sperm and embryo cryopreservation should be considered standard practice and be widely available for those at significant risk of infertility. For prepubertal girls, ovarian tissue cryopreservation should be considered if the risk of premature menopause is high, but for the prepubertal boy there are no established techniques in current practice. Cancer 2011;117(10 suppl):2301–10. © 2011 American Cancer Society.

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“…The included studies were published between 1999 and 2014, and all of them were cohort studies [4,[6][7][8][9][10][11][12][13][14][15][16][17][18]. A total of 10,717 women with radiation therapy and 11,128 women without radiation therapy from 13 studies were evaluated [4, 6-15, 17, 18].…”

Section: Resultsmentioning

confidence: 99%

“…In fertility factors, 5 studies were described about infertility [6,9.12,14, 18], 2 studies were based on AMH values [4,17], 2 studies on AOF [10,16], 3 studies on stillbirth or neonatal death [7,8,13], 2 studies on spontaneous abortion [7,12], 2 studies on congenital anomaly [7,15], 2 studies on low birth weight [7,11] and 1 study on preterm birth [11]. In radiation therapy methods, 4 studies were performed in radiation therapy without specific description [10,12,16,2], 2 studies on abd-pelvic radiation [6,7], 2 studies on ovarian radiation [8,15] and each of the 6 last studies were performed on pelvic radiation [4], abdominal or total body radiation [17], hypothalamic or pituitary radiation [14], nasopharyngeal radium irradiation [9], uterus radiation [11], uterus and ovarian radiation [13].…”

Section: Resultsmentioning

confidence: 99%

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Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Gao

Liang

Qiu

2015

J Assist Reprod Genet

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Background and aims Many epidemiological studies have revealed a positive correlation between medical radiation exposure and the reproductive health in female childhood cancer survivors. However, because of variations in the samples size, such studies showed partly inconsistent conclusions. The aim of this meta-analysis was to clarify the association between radiotherapy and the risk of reproductive health impairment for female who survived from childhood cancer. Methods Fourteen cohort studies involving childhood radiotherapy were selected as the exposure of interest and the impaired reproductive health condition during the childbearing age as the outcome. Among meta-analysis of observational studies found in Pubmed and Embase from 1900 to 2014, we evaluated those relevant observational studies which surveyed the association of medical radiation and reproductive health in female childhood cancer survivors. Review Manager 5.2 and STATA 12.0 software were used to perform the metaanalysis. Study-specific estimations for each outcome were combined into a pooled relative risk (RR) with 95 % confidence interval (CI) by a meta-analytic approach.Results Based on a random-effects meta-analysis, significant association between infertility (RR=1.28, 95 % CI=1.16-1.42), acute ovarian failure (AOF) (RR=9.51, 95 % CI=5.03-17.96), low level of anti mullerian hormone (AMH) (<1 ng/mL) (RR=14.79, 95 % CI=3.36-66.64), stillbirth (RR=1.19, 95 % CI=1.02-1.39) and low birth weight (RR=2.22, 95 % CI= 1.55-3.17) were identified. Conversely, no significant results were found in abortion and congenital malformations. Conclusions To the best of our knowledge, this is the first meta-analysis assessing the effect of medical radiation on female childhood cancer survivors' reproductive capability and pregnancy outcomes. Although there were some limitations, our meta-analysis further supported that radiotherapy was a risk factor for reproductive health problems of female who survived from childhood cancer.

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Female Survivors of Childhood Cancer: Preterm Birth and Low Birth Weight Among Their Children

Abstract: Late effects of treatment for female childhood cancer patients may include restricted fetal growth and early births among their offspring, with risks concentrated among women who receive pelvic irradiation.

Cited by 258 publications

References 34 publications

Hodgkin's disease and birth outcome: a Danish nationwide cohort study

Hodgkin's disease and birth outcome: a Danish nationwide cohort study

Oncofertility and preservation of reproductive capacity in children and young adults

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

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