| Autor: |
Cochrane C; Department of OB/Gyn, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA., Anderson C; Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Mitra S; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Green L; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Baggett CD; Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Mersereau JE; Shady Grove Fertility, Raleigh, North Carolina, USA., Getahun D; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA., Kwan ML; Division of Research, Kaiser Permanente Northern California, Oakland, California, USA., Chao CR; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA., Kushi LH; Division of Research, Kaiser Permanente Northern California, Oakland, California, USA., Nichols HB; Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. |
| Abstrakt: |
Objective: To describe patterns of cancer treatment and live birth outcomes that followed a cancer diagnosis during pregnancy. Study Design: The Adolescent and Young Adult (AYA) Horizon Study is an observational study evaluating outcomes in survivors of the five most common types of cancer in this age group (15-39 years old). Of the 23,629 individuals identified diagnosed with breast, lymphoma, thyroid, melanoma, or gynecological cancer in North Carolina (2000-2015) and California (2004-2016), we identified 555 live births to individuals who experienced cancer diagnosis during pregnancy. Births to individuals diagnosed with cancer during pregnancy were matched ∼1:5 on maternal age and year of delivery to live births to individuals without a cancer diagnosis ( N = 2,667). Multivariable Poisson regression was used to compare birth outcomes between pregnancies affected by a cancer diagnosis and unaffected matched pregnancies. Results: Cancer diagnosis during pregnancy was associated with an increased risk of preterm delivery (prevalence ratio [PR] 2.70; 95% confidence interval [CI] 2.24, 3.26); very preterm delivery (PR 1.74; 95% CI 1.12, 2.71); induction of labor (PR 1.48; 95% CI 1.27, 1.73); low birth weight (PR 1.97; 95% CI 1.55, 2.50); and cesarean delivery (PR 1.18; 95% CI 1.04, 1.34) but not associated with low Apgar score (PR 0.90; 95% CI 0.39, 2.06). In our sample, 41% of patients received chemotherapy, half of whom initiated chemotherapy during pregnancy, and 86% received surgery, 58% of whom had surgery during pregnancy. Of the 19% who received radiation, all received radiation treatment following pregnancy. Conclusion: We identified an increased risk of birth outcomes, including preterm and very preterm delivery, induction of labor, low birth weight, and cesarean delivery, to those experiencing a cancer diagnosis during pregnancy. This analysis contributes to the available evidence for those experiencing a cancer diagnosis during pregnancy. |
