title: Perinatal outcome in pregnant women with cancer: are there any effects of chemotherapy?
abstract: Cancer is the leading cause of death in women of reproductive age. During the last decades and especially in developed countries, the incidence of cancer is increasing dramatically, with an incidence of 1 in 1,000 pregnancies. This is mostly related to delay of pregnancy into the late reproductive years. The aim of this study was to investigate the outcome of pregnancy in women with diagnosis of cancer; in particular, neonatal morbidity and mortality, after in utero exposure to chemotherapy, were evaluated. A total of 59 singletons and one twin pregnancy complicated by cancer were followed at our tertiary centre over the last 15 years. A different treatment, based on surgery and/or chemotherapy in pregnancy or delayed to the postpartum period, was employed. There were 59 live births (97%), one foetal loss and one stillbirth at 28 weeks. The congenital malformation rate was 5% (n = 3). The rate of preterm birth was 83%. The mean birthweight and mean birthweight percentile were 2,098 g (740-3930) and 46 (7-93), respectively; 32% of neonates were small for gestational age (SGA). Dividing the population into treated or untreated with chemotherapy, the rate of SGA was not statistically significant different between the two groups. Our results showed that chemotherapy administered during the second trimester or later did not influence intrauterine foetal growth, but the high prevalence of SGA neonates in the two groups, exposed or not exposed to chemotherapy, suggests an influence of maternal cancer per se on foetal growth.
authors.affiliation: High Risk Pregnancy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Garofalo
authors.affiliation: High Risk Pregnancy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: V A
authors.initials: VA
authors.lastname: Degennaro
authors.affiliation: High Risk Pregnancy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Salvi
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: De Carolis
authors.affiliation: Department of Hygiene, University of Cassino, Cassino, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Capelli
authors.affiliation: High Risk Pregnancy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ferrazzani
authors.affiliation: High Risk Pregnancy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: De Carolis
authors.affiliation: High Risk Pregnancy Unit, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lanzone
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001724:Birth Weight; D001859:Bone Neoplasms / Q000628:therapy; D001943:Breast Neoplasms / Q000628:therapy; D016543:Central Nervous System Neoplasms / Q000628:therapy; D015179:Colorectal Neoplasms / Q000628:therapy; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008175:Lung Neoplasms / Q000628:therapy; D008545:Melanoma / Q000628:therapy; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000628:therapy*; D012516:Osteosarcoma / Q000628:therapy; D010051:Ovarian Neoplasms / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy*; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000628:therapy; D013274:Stomach Neoplasms / Q000628:therapy; D013514:Surgical Procedures, Operative; D002583:Uterine Cervical Neoplasms / Q000628:therapy
keywords: cancer; chemotherapy; perinatal outcome; pregnancy; small gestational age