ESPEYB21 9. Oncology and Chronic Disease Fertility Issues (9 abstracts)
9.9. Risk of adverse birth outcomes after adolescent and young adult cancer
Anderson C , Baggett CD , Engel SM , Getahun D , Cannizzaro NT , Mitra S , Meernik C , Moy LM , Laurent CA , Zhou X , Xu L , Kwan ML , Wood WA , Luke B , Chao CR , Kushi LH & Nichols HB
chelsea_anderson@med.unc.edu JNCI Cancer Spectr. 2024 Jan 4;8(1): pkad106. doi: 10.1093/jncics/pkad106. PMID: 38127994
Brief Summary: This retrospective cohort study analysed risk ratios for preterm birth (<37 completed weeks), very preterm birth (<34 completed weeks), low birth weight (<2500 g), and small for gestational age (SGA, <10th percentile of weight for gestational age) in a large group of women diagnosed with adolescent and young adult (AYA, age 15-39 years) breast cancer, thyroid cancer, gynaecologic cancers, lymphoma, or melanoma.
1648 post-cancer births were each matched to 5 births of women without cancer. Overall, the risks of preterm birth, very preterm birth, low birth weight, and SGA did not differ between births to AYA survivors and women without cancer. However, women with gynaecologic cancers had increased risk of low birth weight and a slightly increased risk of preterm birth. Chemotherapy exposure was not associated with risk of adverse birth outcomes. In stratified analyses, the risk of preterm birth to women who smoked during pregnancy was increased for AYA cancer survivors compared to women without a cancer history. AYA cancer survivors with a pre-pregnancy obesity also had an increased risk of preterm birth and low birth weight, compared to women with a similar pre-pregnacy BMI but without a history of cancer.
Cancers diagnosed among AYA occurs in a critical life period where decisions for childbearing and parenthood are made. With a 5-year survival rate >85% for all cancers combined in this age group, many AYA women will live long enough to have biological children, and be impacted by the effects of their cancer treatment on their reproductive outcome. Previous studies, mostly including women diagnosed with cancer prior to the year 2000, reported a higher rate of preterm births and low birth weight among cancer survivors compared to the general population. This study does not confirm such risks of adverse birth outcomes, except for AYA survivors of gynaecologic cancers or those who carry additional risk factors, such as obesity or smoking.
Given the relatively small sample size, the authors could not conduct more specific analyses for cancer types (cervical, ovarian, uterine). However, the increased risk due to gynecological cancers is highly plausible, given the anatomical location of these malignant tumors and their treatments (pelvic surgery and/or radiation therapy).
References: 1. van der Kooi ALF, Brewster DH, Wood R, et al. Perinatal risks in female cancer survivors: a population-based analysis. PLoS One. 2018;13(8): e0202805.2. Huang W, Sundquist K, Sundquist J, Ji J. Risk of being born preterm in offspring of cancer survivors: a national cohort study. Front Oncol. 2020; 10:1352
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ESPE Yearbook of Paediatric Endocrinology
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