title: Congenital malformations in offspring of women with a history of malignancy.
abstract: BACKGROUND
  Survival after malignancy has increased and the question of risks, including risk for congenital malformations for the offspring of these women has become important. Data on congenital malformations in such offspring are limited.
  
  
  METHODS
  We compared congenital malformation in offspring, born 1994 to 2011 of women with a history of malignancy (at least 1 year before delivery) with all other offspring. Adjustment for confounders was mainly made by Mantel-Haenszel methodology. Data were obtained by linkage between Swedish national health registers.
  
  
  RESULTS
  We identified 71,954 (4.1%) infants with congenital malformation, of which 47,081 (2.7%) were relatively severe (roughly corresponding to major malformation). Among 7284 infants to women with a history of malignancy 204 relatively severe malformations were found (2.8%; odds ratio [OR] = 1.04; 95% confidence interval [CI], 0.91-1.20). After in vitro fertilization, the risk of a relatively severe malformation was significantly increased in women without a history of malignancy (OR = 1.31; 95% CI, 1.24-1.38) and still more in women with such a history (risk ratio = 1.85; 95% CI, 1.08-2.97). However, there were no significant differences neither, for any malformations (OR = 1.04; 95% CI, 0.92-1.16) nor for relatively severe malformations (OR = 1.04; 95% CI, 0.91-1.20), when comparing offspring only after maternal history of malignancy.
  
  
  CONCLUSIONS
  No general increase in malformation rate was found in infants born to women with a history of malignancy. A previously known increased risk after in vitro fertilization was verified and it is possible that this risk is further augmented among infants born of women with a history of malignancy. Birth Defects Research 109:224-233, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Centre of Reproductive Medicine, Skane University Hospital, Malmö, Sweden.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sabeti Rad
authors.affiliation: Centre of Reproductive Medicine, Skane University Hospital, Malmö, Sweden.
authors.forename: Britt
authors.initials: B
authors.lastname: Friberg
authors.affiliation: Centre of Reproductive Medicine, Skane University Hospital, Malmö, Sweden.
authors.forename: Emir
authors.initials: E
authors.lastname: Henic
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rylander
authors.affiliation: Department of Oncology, Skane University Hospital, Lund, Sweden.
authors.forename: Olof
authors.initials: O
authors.lastname: Ståhl
authors.affiliation: Tornblad Institute, Lund University, Lund, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Källén
authors.affiliation: Department of Obstetric and Gynecology, Skane University Hospital, Lund, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Lingman
mesh_terms: D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000209:etiology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D036801:Parturition / Q000502:physiology; D011247:Pregnancy; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: IVF; congenital malformations; malignancy; maternal malignant disease; offspring