TY - JOUR
T1 - Cancer in pregnancy and the risk of adverse pregnancy and neonatal outcomes
T2 - a nationwide cohort study
AU - Greiber, Iben Katinka
AU - Viuff, Jakob Hansen
AU - Mellemkjaer, Lene
AU - Hjortshøj, Cristel Sørensen
AU - Lidegaard, Øjvind
AU - Storgaard, Lone
AU - Karlsen, Mona Aarenstrup
N1 - © 2022 John Wiley & Sons Ltd.
PY - 2022/8
Y1 - 2022/8
N2 - OBJECTIVES: To investigate the obstetrical management of cancer in pregnancy and to determine adverse pregnancy and neonatal outcomes.DESIGN: A nationwide cohort study.SETTING AND POPULATION: We included all pregnancies (n = 4 071 848) in Denmark from 1 January 1973 to 31 December 2018.METHODS: Exposure was defined as pregnancies exposed to maternal cancer (n = 1068). The control group comprised pregnancies without cancer. The groups were compared using logistic regression analysis and adjusted for potential confounders.MAIN OUTCOME MEASURES: The outcomes were induced abortion, preterm birth and adverse neonatal outcomes.RESULTS: More women with cancer in pregnancy, as compared with the control group, experienced induced abortion (24.8% vs. 20.0%); first-trimester induced abortion adjusted odds ratio (aOR) 3.5 (95% confidence interval [CI] 2.7-4.5), second-trimester induced abortion; aOR 8.8 (95% CI 6.3-12.3), planned preterm birth (11.8% vs. 1.3%); aOR 10.8 (95% CI 8.0-14.6) and planned preterm birth at <32 gestational weeks; aOR 16.3 (95% CI 8.3-31.7). Neonates born to mothers with cancer in pregnancy had a higher risk of respiratory distress syndrome; aOR 3.5 (95% CI 2.8-4.4), low birthweight; aOR 3.8 (95% CI 3.1-4.8), admission to neonatal intensive care unit for >7 days; aOR 5.1 (95% CI 3.9-6.6), neonatal infection; aOR 1.8 (95% CI1.1-3.1) and neonatal mortality; aOR 4.7 (95% CI 2.7-8.2), but not of SGA; aOR 1.0 (95% CI 0.6-1.5) and malformations; 1.2 (95% CI 0.9-1.7).CONCLUSION: Cancer in pregnancy increases the risk of induced abortion and planned premature birth. Neonates born to mothers with cancer in pregnancy had an increased risk of neonatal morbidity and mortality, presumably due to prematurity.TWEETABLE ABSTRACT: Cancer in pregnancy is associated with an increased risk of premature birth leading to adverse neonatal outcomes.
AB - OBJECTIVES: To investigate the obstetrical management of cancer in pregnancy and to determine adverse pregnancy and neonatal outcomes.DESIGN: A nationwide cohort study.SETTING AND POPULATION: We included all pregnancies (n = 4 071 848) in Denmark from 1 January 1973 to 31 December 2018.METHODS: Exposure was defined as pregnancies exposed to maternal cancer (n = 1068). The control group comprised pregnancies without cancer. The groups were compared using logistic regression analysis and adjusted for potential confounders.MAIN OUTCOME MEASURES: The outcomes were induced abortion, preterm birth and adverse neonatal outcomes.RESULTS: More women with cancer in pregnancy, as compared with the control group, experienced induced abortion (24.8% vs. 20.0%); first-trimester induced abortion adjusted odds ratio (aOR) 3.5 (95% confidence interval [CI] 2.7-4.5), second-trimester induced abortion; aOR 8.8 (95% CI 6.3-12.3), planned preterm birth (11.8% vs. 1.3%); aOR 10.8 (95% CI 8.0-14.6) and planned preterm birth at <32 gestational weeks; aOR 16.3 (95% CI 8.3-31.7). Neonates born to mothers with cancer in pregnancy had a higher risk of respiratory distress syndrome; aOR 3.5 (95% CI 2.8-4.4), low birthweight; aOR 3.8 (95% CI 3.1-4.8), admission to neonatal intensive care unit for >7 days; aOR 5.1 (95% CI 3.9-6.6), neonatal infection; aOR 1.8 (95% CI1.1-3.1) and neonatal mortality; aOR 4.7 (95% CI 2.7-8.2), but not of SGA; aOR 1.0 (95% CI 0.6-1.5) and malformations; 1.2 (95% CI 0.9-1.7).CONCLUSION: Cancer in pregnancy increases the risk of induced abortion and planned premature birth. Neonates born to mothers with cancer in pregnancy had an increased risk of neonatal morbidity and mortality, presumably due to prematurity.TWEETABLE ABSTRACT: Cancer in pregnancy is associated with an increased risk of premature birth leading to adverse neonatal outcomes.
KW - cancer in pregnancy
KW - chemotherapy treatment
KW - iatrogenic prematurity
KW - neonatal outcomes
KW - obstetrical management
KW - pregnancy outcome
KW - pregnancy-associated cancer
KW - prematurity
KW - termination of pregnancy planned preterm birth
KW - Infant Mortality
KW - Humans
KW - Pregnancy
KW - Pregnancy Complications/epidemiology
KW - Premature Birth/epidemiology
KW - Female
KW - Infant, Newborn
KW - Neoplasms/epidemiology
KW - Pregnancy Outcome
KW - Cohort Studies
U2 - 10.1111/1471-0528.17074
DO - 10.1111/1471-0528.17074
M3 - Article
C2 - 34954890
SN - 1470-0328
VL - 129
SP - 1492
EP - 1502
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 9
ER -