Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study

Fatima A. Haggar*, Gavin Pereira, David Preen, C. D'Arcy Holman, Kristjana Einarsdottir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Objective: To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods: Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n=1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982-2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. Results: Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51-2.74), gestational diabetes (2.65, 2.08-3.57), preeclampsia (1.32, 1.04-1.87), post-partum hemorrhage (2.83, 1.92-4.67), cesarean delivery (2.62, 2.22-3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72-5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21-2.08), low birth weight (<2500 g: 1.51, 1.23-2.12), fetal growth restriction (3.27, 2.45-4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28-3.56), need for resuscitation (1.66, 1.27-2.19) or special care nursery admission (1.44, 1.13-1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors. Conclusion: Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention.

Original languageEnglish
Article numbere113292
JournalPLoS ONE
Volume9
Issue number12
DOIs
Publication statusPublished - 8 Dec 2014

Bibliographical note

Publisher Copyright:
© 2014 Haggar et al.

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