Risk of Being Born Preterm in Offspring of Cancer Survivors: A National Cohort Study

Huang, Wuqing; Sundquist, Kristina; Sundquist, Jan; Ji, Jianguang

doi:10.3389/fonc.2020.01352

Cited by 5 publications

(5 citation statements)

References 38 publications

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“…The findings of this study are consistent with previous findings showing an increase in the rates of preterm birth and low birth weight in the offspring of cancer survivors 9 , 10 , 15 . There have been reports that offspring of female survivors of adolescent and young adult cancer had an increased risk of admission to a special care unit in population-based cohort studies from Western Australia 16 and Finland 17 .…”

Section: Discussionsupporting

confidence: 93%

Perinatal and childhood outcomes of children born to female cancer survivors in South Korea

Jin,

Youk,

Yun

et al. 2024

Sci Rep

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Despite the increasing number of female cancer survivors, uncertainty remains regarding potential adverse health outcomes for their offspring. Comprehensive population-based studies would be invaluable for female cancer survivors in making decisions about their future. This study uses the National Health Information Database to investigate perinatal and long-term outcomes of offspring born to mothers with a history of cancer. In a South Korean cohort of 95,264 women aged 15–40 diagnosed with cancer between 2007 and 2010, we evaluated the outcomes of 15,221 children born to 11,092, cancer survivors. We selected 147,727 women without a history of cancer and 201,444 children as a control group. Our study found that children of female cancer survivors have a significantly higher odds ratio of primary outcomes including preterm birth, low birth weight, neonatal intensive care unit admission, and death. While there was no difference in the rate of death within 1 year of birth between the two groups, the total death rate during the follow-up period was significantly higher in children born to mothers with cancer. After adjusting for gestational age and birth weight, there was no statistically significant increased hazard ratio of secondary outcomes including cancer, chromosomal abnormalities, cerebral palsy, delayed development, epilepsy, language disorder, or hearing impairment.

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Section: Discussionsupporting

confidence: 93%

Perinatal and childhood outcomes of children born to female cancer survivors in South Korea

Jin,

Youk,

Yun

et al. 2024

Sci Rep

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“…A total of 93 (70.5%) pregnancies ended preterm, a similar figure to the reported rates of preterm deliveries in pregnant patients with cancer [ 25 – 27 ]. Preterm delivery as an adverse effect of chemotherapy has been extensively reported, both when administered prior to pregnancy and throughout [ 28 , 29 ]. The mechanisms that associate preterm delivery with chemotherapy are incompletely understood, but might involve placental underdevelopment, reduction of regulatory T cell populations, and apoptosis of fetal membranes [ 29 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review

Aranda-Gutierrez,

Ferrigno Guajardo,

Vaca-Cartagena

et al. 2024

BMC Cancer

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Background The use of taxanes following the first trimester of pregnancy is endorsed by current clinical guidelines. However, evidence regarding their safety in terms of obstetric and neonatal outcomes is limited. Methods A comprehensive literature search was performed using the MEDLINE, CENTRAL and Web of Sciences databases from their inception up to 12/16/2022. Eligibility criteria included gestational taxane use, presentation of original findings, and individual case data presented. A descriptive statistical analysis was undertaken. Results A total of 159 patients treated with taxane-containing regimens during pregnancy were identified, resulting in 162 fetuses exposed in utero. The majority of patients had breast cancer (n = 88; 55.3%) or cervical cancer (n = 45; 28.3%). The most commonly employed taxane was paclitaxel (n = 131; 82.4%). A total of 111 (69.8%) patients were also treated with other cytotoxic drugs during pregnancy, including platinum salts (n = 70; 63.0%) and doxorubicin/cyclophosphamide (n = 20; 18.0%). While most patients received taxanes during the second trimester of pregnancy (n = 79; 70.0%), two were exposed to taxanes in the first trimester. Obstetric outcomes were reported in 105 (66.0%) cases, with the most frequent adverse events being preterm contractions or premature rupture of membranes (n = 12; 11.4%), pre-eclampsia/HELLP syndrome (n = 6; 5.7%), and oligohydramnios/anhydramnios (n = 6; 5.7%). All cases with pregnancy outcome available resulted in live births (n = 132). Overall, 72 (54.5%) neonates were delivered preterm, 40 (30.3%) were classified as small for gestational age (SGA), and 2 (1.5%) had an Apgar score of < 7 at 5 min. Perinatal complications included acute respiratory distress syndrome (n = 14; 10.6%), hyperbilirubinemia (n = 5; 3.8%), and hypoglycemia (n = 2; 1.5%). In addition, 7 (5.3%) cases of congenital malformations were reported. At a median follow-up of 16 months, offspring health status was available for 86 (65.2%), of which 13 (15.1%) had a documented complication, including delayed speech development, recurrent otitis media, and acute myeloid leukemia. Conclusions Taxanes appear to be safe following the first trimester of pregnancy, with obstetric and fetal outcomes being similar to those observed in the general obstetric population. Future studies should aim to determine the most effective taxane regimen and dosage for use during gestation, with a specific focus on treatment safety.

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“…Several European studies, most including women diagnosed with cancer prior to the year 2000, have reported a significant increase in preterm births and LBW among cancer survivors compared to the general population, with relative risks generally ranging from about 1.2 to 2.0 for both outcomes ( 3-7 , 9 , 10 ). US-based studies are fewer in number but have often had similar findings.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies have investigated births to cancer survivors, with most finding a small to moderate increase in the risk of preterm birth and low birth weight (LBW), but no difference in risk of small for gestational age (SGA) births, compared with births to women without a history of cancer ( 2-16 ). However, these studies have often included births to childhood cancer survivors (diagnosed before age 15 years) ( 6 , 7 , 9 , 10 , 12-14 ), who may differ substantially from AYA cancer survivors in their distribution of cancer types, cancer treatment-related exposures, and interval between cancer diagnosis or treatment and subsequent pregnancy. Most studies focused on survivors diagnosed with cancer as AYAs have come from Europe ( 3-5 ) and therefore may not reflect patterns of cancer or reproductive health care for US patients or rates of adverse birth outcomes in the US general population.…”

mentioning

confidence: 99%

“…Most studies focused on survivors diagnosed with cancer as AYAs have come from Europe ( 3-5 ) and therefore may not reflect patterns of cancer or reproductive health care for US patients or rates of adverse birth outcomes in the US general population. Many prior studies have also lacked cancer treatment information ( 3 , 5-7 , 9 , 10 , 13 ), which is critical for understanding whether exposure to certain therapies contributes to the excess risk of preterm birth or other adverse outcomes among survivors. Additional evidence is needed to inform reproductive counseling for US cancer patients diagnosed and treated as AYAs.…”

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confidence: 99%

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Risk of adverse birth outcomes after adolescent and young adult cancer

Anderson,

Baggett,

Engel

et al. 2023

JNCI Cancer Spectrum

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Background Many women diagnosed with cancer as adolescents and young adults (AYAs, ages 15-39 years) want biological children after cancer but lack information on the potential impact of their cancer history on future reproductive outcomes. We investigated the risk of adverse birth outcomes among AYA cancer survivors. Methods We identified insured women diagnosed with AYA breast cancer, thyroid cancer, gynecologic cancers, lymphoma, or melanoma from 2003 to 2016 in the state of North Carolina or the Kaiser Permanente healthcare systems in Northern and Southern California. Post-diagnosis births to cancer survivors were each matched with up to 5 births to women without cancer. Risk ratios for preterm birth (<37 completed weeks,) very preterm birth (<34 completed weeks), low birth weight (<2,500 g), and small for gestational age (SGA, < 10th percentile of weight for gestational age) were estimated using modified Poisson regression. Results Analyses included 1,648 births to 1,268 AYA cancer survivors and 7,879 births to 6,066 women without cancer. Overall, risk of preterm birth, very preterm birth, low birth weight, and SGA did not significantly differ between births to women with and without cancer. However, births to women with gynecologic cancers had a significantly increased risk of low birth weight (RR = 1.82; 95% CI: 1.03-3.21) and suggested increased risk of preterm birth (RR = 1.59; 95% CI: 0.99-2.54). Chemotherapy exposure was not associated with increased risk of adverse birth outcomes. Conclusions Women with gynecologic cancers, but not other cancers, had an increased risk of adverse birth outcomes compared to women without cancer.

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Risk of Being Born Preterm in Offspring of Cancer Survivors: A National Cohort Study

Cited by 5 publications

References 38 publications

Perinatal and childhood outcomes of children born to female cancer survivors in South Korea

Perinatal and childhood outcomes of children born to female cancer survivors in South Korea

Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review

Risk of adverse birth outcomes after adolescent and young adult cancer

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