Pregnancy outcomes in female childhood and adolescent cancer survivors: a linked cancer-birth registry analysis.
OBJECTIVE
To compare birth outcomes among female survivors of childhood and adolescent cancer who subsequently bear children, relative to those of women without a history of cancer.


METHODS
Retrospective cohort study.


METHODS
Four US regions.


METHODS
Cancer registries identified girls younger than 20 years who were diagnosed as having cancer from 1973 through 2000. Linked birth records identified the first live births after diagnosis (n = 1898). Comparison subjects were selected from birth records (n = 14 278). Survivors of genital tract carcinomas underwent separate analysis.


METHODS
Cancer diagnosis at younger than 20 years.


METHODS
Infant low birth weight, preterm delivery, sex ratio, malformations, mortality, and delivery method, and maternal diabetes, anemia, and preeclampsia.


RESULTS
Infants born to childhood cancer survivors were more likely to be preterm (relative risk [RR], 1.54; 95% confidence interval [CI], 1.30-1.83) and to weigh less than 2500 g (1.31; 1.10-1.57). For the offspring of genital tract carcinoma survivors, RRs were 1.33 (95% CI, 1.13-1.56) and 1.29 (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 (3.05; 1.16-7.98) and childhood cancer survivors whose initial treatment was chemotherapy only (2.45; 1.16-5.17).


CONCLUSIONS
Infants born to female survivors of childhood and adolescent cancer were not at increased risk of malformations or death. Increased occurrence of preterm delivery and low birth weight suggest that close monitoring is warranted. Increased diabetes and anemia among subgroups have not been reported, suggesting areas for study.
Mueller
Beth A
BA
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Chow
Eric J
EJ
Kamineni
Aruna
A
Daling
Janet R
JR
Fraser
Alison
A
Wiggins
Charles L
CL
Mineau
Geraldine P
GP
Hamre
Merlin R
MR
Severson
Richard K
RK
Drews-Botsch
Carolyn
C
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
D000970:Antineoplastic Agents