title: Effects of prenatal exposure to cancer treatment on neurocognitive development, a review.
abstract: Due to the increasing incidence of cancer during pregnancy, the need to better understand long-term outcome after prenatal exposure to chemo- and/or radiotherapy has become more urgent. This manuscript focuses on the neurocognitive development after prenatal exposure to cancer treatment. We will review possible pathways for brain damage that could explain the subtle changes in neurocognition and behavior found after in utero exposure to cancer treatment. Contrary to radiation, which has a direct effect on the developing nervous system, chemotherapy has to pass the placental and blood brain barrier to reach the fetal brain. However, there are also indirect effects such as inflammation and oxidative stress. Furthermore, the indirect effects of the cancer itself and its treatment, e.g., poor maternal nutrition and high maternal stress, as well as prematurity, can be related to cognitive impairment. Although the available evidence suggests that cancer treatment can be administered during pregnancy without jeopardizing the fetal chances, larger numbers and longer follow up of these children are needed.
authors.affiliation: KU Leuven-University of Leuven, Department of Oncology, University Hospitals Leuven, Department of Obstetrics and Gynecology, Gynecological Oncology, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: dorothee.vercruysse@uzleuven.be.
authors.forename: Dorothée C-M
authors.initials: DC
authors.lastname: Vercruysse
authors.affiliation: KU Leuven-University of Leuven, Department of Radiology, University Hospitals Leuven, Department of Radiology, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: sabine.deprez@uzleuven.be.
authors.forename: Sabine
authors.initials: S
authors.lastname: Deprez
authors.affiliation: KU Leuven-University of Leuven, Department of Radiology, University Hospitals Leuven, Department of Radiology, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: stefan.sunaert@uzleuven.be.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
authors.affiliation: KU Leuven-University of Leuven, Department of Obstetrics and Gynecology, University Hospitals Leuven, Department of Obstetrics and Gynecology, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: kristel.vancalsteren@uzleuven.be.
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Calsteren
authors.affiliation: KU Leuven-University of Leuven, Department of Oncology, B-3000 Leuven, Belgium; The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: frederic.amant@uzleuven.be.
authors.forename: Frederic
authors.initials: F
authors.lastname: Amant
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003072:Cognition Disorders / Q000209:etiology*; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Chemotherapy; Neurocognitive development; Pregnancy; Radiotherapy