Pregnancy of patients with Hodgkin's disease in remission

Maternal and perinatal outcomes following a diagnosis of Hodgkin lymphoma during or prior to pregnancy: A systematic review

“…Twenty‐three studies included miscarriage as an outcome 43,44,46,48–55,57,58,60,62–64,66,68–72 . Pooled aORs for miscarriage were also not significant for either the group treated for HL before pregnancy (two studies, 62 events, 491 pregnancies, aOR 0.78, 95% CI 0.55–1.10, I 2 = 0%) or the group diagnosed with HL during pregnancy (one study, one event, 638 pregnancies, aOR 0.38, 95% CI 0.05–2.72, I 2 = NC), compared with pregnant women never diagnosed with HL (Figure 3; Table 1).…”

“…Twenty studies included congenital malformations as an outcome 44,46,48–54,57,58,61–65,68–70,72 . The adjusted ORs (aORs) for both the group treated for HL before pregnancy (one study, 11 events, 181 births, aOR 1.7, 95% CI 0.9–3.1, I 2 = not calculable, NC) and the group diagnosed with HL during pregnancy (two studies, six events, 651 births, aOR 1.84, 95% CI 0.81–4.15, I 2 = 0) were not statistically significant compared with pregnant women never diagnosed with HL (Figure 1; Table 1).…”

“…Pooled aORs for miscarriage were also not significant for either the group treated for HL before pregnancy (two studies, 62 events, 491 pregnancies, aOR 0.78, 95% CI 0.55–1.10, I 2 = 0%) or the group diagnosed with HL during pregnancy (one study, one event, 638 pregnancies, aOR 0.38, 95% CI 0.05–2.72, I 2 = NC), compared with pregnant women never diagnosed with HL (Figure 3; Table 1). 53 Compared with the group never diagnosed with HL (four studies, 33 266 events, 7 918 650 pregnancies, 7%, 95% CI 0–22%, I 2 = 99.67%, p = 0.00), the proportion of miscarriages was not significantly increased in the group treated for HL before pregnancy (12 studies, 266 events, 2024 pregnancies, 10%, 95% CI 7–13%, I 2 = 60.72%, p = 0.00), 43,46,49–51,55,57,60,62,68,69,72 or the group diagnosed with HL during pregnancy (13 studies, 14 events, 1009 pregnancies, 1%, 95% CI 0–5%, I 2 = 68.29%, p = 0.00) (Figure S5). 44,48,49,52–54,58,63,64,66,70–72 There was no difference according to the timing of therapy in the group with HL diagnosed during pregnancy, with pooled proportions of 0% for both women who did (seven studies, three events, 114 pregnancies) and women who did not (three studies, zero events, 20 pregnancies) receive antenatal therapy (Figure S6).…”

“… 72 Included studies described pregnancies of 3058 survivors of HL, 1150 women with HL and 25 196 997 women never diagnosed with HL. Two studies included that were not published in English were translated by Polish and German researchers who were native speakers known to the study authors 49,68 . The characteristics of the included studies are summarised in Tables S1 and S2.…”

“…54,61,64 Pooled aORs were not statistically significant for both the group treated for HL before pregnancy, which contained 38 events among two studies of 537 births (0.99, 95% CI 0.65-1.51, I 2 = 0%), and the group diagnosed with HL during pregnancy, which contained 94 events among two studies of 653 births (6.74, 95% CI 0.52-88.03, I 2 = 95%), compared with pregnant women never diagnosed with HL (Figure 2; Table 1). In the group diagnosed with HL during pregnancy (12 studies, 189 events among 1036 births), 48,53,54,61,[63][64][65][66][70][71][72][73] the proportion of PTB was higher (18%, 95% CI 10-28%, I 2 = 86.35%, p = 0.00) than in the group with HL before pregnancy (10 studies, 176 events among 1697 births, 8%, 95% CI 5-12%, I 2 = 82.97%, p = 0.00), 12,43,46,47,51,56,57,61,68,69 and the group never diagnosed with HL (nine studies, 995 084 events among 12 377 598 births, 7%, 95% CI 6-8%, I 2 = 99.96%, p = 0.00) (Figure S3). 12,47,53,56,57,61,63,69,73 There was no significant difference in proportions among those who received antenatal therapy (six studies, 47 events, 176 births, 19%, 95% CI 6-36%, I 2 = 81.21%, p = 0.00) compared with those who did not (two studies, 26 events, 55 births, 47%, 95% CI 34-61%, I 2 = NC, p = NC) (Figure S4).…”