Preterm delivery and future maternal risk of female malignancies.
OBJECTIVE
To investigate whether an association exists between preterm delivery and a future risk for female malignancies.


METHODS
A population-based study compared the incidence of long-term female malignancies in a cohort of women with and without a history of PTD. Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years. We excluded women with known genetic predisposition or malignancies prior to the index pregnancy. Malignancies investigated included ovarian, uterine, breast and cervix. Cumulative incidence was assessed using a Kaplan-Meier survival curve. A Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for female malignancy.


RESULTS
During the study period, 105,033 women met the inclusion criteria; 16.8 % (n = 17,596) of the patients delivered preterm. Patients with a history of PTD did not have an increased risk of later being diagnosed with female malignancies. The results remained insignificant in a sub-analysis based on malignancy type, early PTD, induced vs. spontaneous, and number of episodes per patient. Kaplan-Meier cumulative incidence was similar between the groups, and the adjusted HR was not significant (1.04, 95 % CI 0.88-1.22; p = 0.665).


CONCLUSIONS
A history of PTD does not appear to elevate the risk for subsequent long-term female malignancies.
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer Sheva, 84101, Israel.
Roy
R
Kessous
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer Sheva, 84101, Israel. Asnatwalfisch@yahoo.com.
Asnat
A
Walfisch
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer Sheva, 84101, Israel.
Mihai
M
Meirovitz
Faculty of Health Sciences, Soroka University Medical Center, Clalit Health Services (Southern District), Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ehud
E
Davidson
Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ruslan
R
Sergienko
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer Sheva, 84101, Israel.
Eyal
http://orcid.org/0000-0002-0454-6874
E
Sheiner
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D009369:Neoplasms / Q000453:epidemiology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
Breast cancer; Genital tract malignancies; Long-term risk; Maternal cancer; Preterm birth