title: Does pregnancy after a diagnosis of melanoma affect prognosis? Systematic review and meta-analysis.
abstract: BACKGROUND
  Whether pregnancy after diagnosis of melanoma affects a woman's prognosis is unknown. The authors conducted a systematic review and meta-analysis to answer this question.
  
  
  OBJECTIVE
  To evaluate the effect of a subsequent pregnancy on cause-specific death and recurrence of melanomas.
  
  
  METHODS
  Five databases (Cochrane Database, MEDLINE, EMBASE, CINAHL, and PubMed) were searched for studies assessing the effect of subsequent pregnancy on risk of melanoma death or recurrence. The authors collated all longitudinal studies of women of childbearing age diagnosed with incident melanoma that compared melanoma outcomes among those who became pregnant after the diagnosis and those who did not. Individual study effect estimates were pooled when available using the weighted average method, and other findings were summarized narratively.
  
  
  RESULTS
  Of 304 citations identified, 5 studies met the inclusion criteria. All 5 assessed melanoma death, and 2 of the 5 assessed recurrence. There was no significant effect of subsequent pregnancy on melanoma mortality after 11 to 20 years of follow-up (pooled hazard ratio, 0.81; 95% confidence interval, 0.60-1.09) and no significant differences in melanoma recurrence. Only one study included patients with all stages of melanoma beyond Stage 1.
  
  
  CONCLUSIONS
  Current evidence does not support the hypothesis that pregnancy subsequent to successful treatment of melanoma worsens prognosis. However, relevant data are sparse, suggesting that a precautionary approach is warranted regarding childbearing advice to melanoma survivors.
authors.affiliation: *UQ Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, Australia; †Experimental Dermatology Group, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia; ‡QIMR Berghofer Medical Research Institute, Brisbane, Australia; §CRUK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom.
authors.forename: Lisa
authors.initials: L
authors.lastname: Byrom
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
authors.forename: Lani
authors.initials: L
authors.lastname: Knight
authors.forename: Kiarash
authors.initials: K
authors.lastname: Khosrotehrani
authors.forename: Adele C
authors.initials: AC
authors.lastname: Green
mesh_terms: D000328:Adult; D002423:Cause of Death; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008545:Melanoma / Q000175:diagnosis / Q000401:mortality*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D016742:Preconception Care; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012878:Skin Neoplasms / Q000175:diagnosis / Q000401:mortality*; D015996:Survival Rate