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Pregnancy outcomes in female childhood and adolescent cancer survivors: a linked cancer-birth registry analysis

Mueller, Beth A. and Chow, Eric J. and Kamineni, Aruna and Daling, Janet R. and Fraser, Alison and Wiggins, Charles L. and Mineau, Geraldine P. and Hamre, Merlin R. and Severson, Richard K. and Drews-Botsch, Carolyn (2009) Pregnancy outcomes in female childhood and adolescent cancer survivors: a linked cancer-birth registry analysis. Archives of Pediatrics & Adolescent Medicine, 163 (10). pp. 879-886. ISSN 1072-4710

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Objective: To compare birth outcomes among childhood and adolescent female cancer survivors who subsequently bear children, relative to those of women without cancer history. Design: Retrospective cohort study. Setting: 4 U.S. regions. Participants: Cancer registries identified girls <20 years, diagnosed with cancer 1973-2000. Linked birth records identified first live births after diagnosis (n=1898). Comparison subjects were selected from birth records (n=14278). Cervical/genital tract cancer cases were analyzed separately. Main Exposure: Cancer diagnosis <20 years. Outcome Measures: Infant low birth weight, preterm delivery, sex ratio, malformations, mortality, delivery method; maternal diabetes, anemia, preeclampsia. Results: Childhood cancer survivors’ infants were more likely to be preterm (relative risk [RR] 1.54, 95% CI 1.30-1.83) and weigh <2500 g (RR 1.31, 95% CI 1.10-1.57). For cervical/genital cancer patients’ offspring, estimates were 1.33 (95% CI 1.13, 1.56), and 1.29 (95% CI 1.10-1.53), respectively. There were no increased risks of malformations, infant death, or altered sex ratio, suggesting no increased germ cell mutagenicity. In exploratory analysis, bone cancer survivors had an increased risk of diabetes (RR 4.92, 95% CI 1.60-15.13), and anemia was more common among brain tumor survivors (RR 3.05, 95% CI 1.16-7.98) and childhood cancer survivors with initial treatment of chemotherapy only (RR 2.45, 95% CI 1.16-5.17). Conclusions: Infants of female childhood and adolescent cancer patients were not at increased risk of malformations or death. Increased occurrence of preterm delivery and low birth weight suggest close monitoring is warranted. Increased diabetes and anemia among sub-groups have not been reported, suggesting areas for study.

Item Type: Article or Abstract
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DOI: 10.1001/archpediatrics.2009.112
PubMed ID: 19805705
PMCID: PMC2758647
Grant Numbers: N01 CN005230, N01 PC035141, N01-PC-05016-20, N01-CN-65064, N01-CN-67000, N01-PC-67006
Keywords or MeSH Headings: * Adolescent * Adult * Antineoplastic Agents/adverse effects* * Case-Control Studies * Child * Child, Preschool * Congenital Abnormalities/epidemiology * Female * Genital Neoplasms, Female/drug therapy * Genital Neoplasms, Female/epidemiology * Genital Neoplasms, Female/radiotherapy * Genital Neoplasms, Female/surgery * Humans * Infant * Infant, Low Birth Weight * Infant, Newborn * Male * Maternal Exposure/adverse effects* * Neoplasms/drug therapy * Neoplasms/epidemiology* * Neoplasms/radiotherapy * Neoplasms/surgery * Pregnancy * Pregnancy Outcome* * Premature Birth/epidemiology * Radiotherapy/adverse effects* * Retrospective Studies * Survivors/statistics & numerical data* * United States/epidemiology
Subjects: Cellular and Organismal Processes > Reproduction
Research Methodologies > Epidemiology
Depositing User: Library Staff
Date Deposited: 29 Jan 2009 18:28
Last Modified: 14 Feb 2012 14:42

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