title: Impact of prior breast cancer on mode of delivery and pregnancy-associated disorders: a retrospective analysis of subsequent pregnancy outcomes.
abstract: OBJECTIVE
  The aim of this paper is to analyze the impact of prior breast cancer (BC) on mode of delivery and pregnancy-associated disorders.
  
  
  METHODS
  A database from 262 German gynecological practices including 289,712 women between the ages of 18 and 45 with documented pregnancies between 2000 and 2014 was used to search for patients with a history of BC up to 10 years prior to pregnancy. A total of 165 patients with a history of BC were found and matched with 165 patients without a history of any cancer (1:1) by age, physician, obesity, and documented referral to a fertility center up to 12 months before the index pregnancy. The impact of prior BC on the mode of delivery and pregnancy-associated disorders was analyzed using Cox regression models.
  
  
  RESULTS
  The mean maternal age at first visit was 34.6 years in both groups. The early and late pregnancy loss was significantly reduced (17.7 versus 29.9%, OR 0.50) and delivery of a live-born child more frequent (82.3 versus 70.1%, OR 2.00) in women who had had BC than in controls. Furthermore, preterm contractions without preterm birth were less frequent in women with BC compared to controls (9.2 versus 18.9%, OR 0.43). No significant differences were found for other pregnancy complications, such as suspected fetal growth restriction, genito-urinary infections, fetal malpresentation, gestational diabetes, pre-eclampsia, or breastfeeding issues.
  
  
  CONCLUSIONS
  Based on the decreased rate of early and late pregnancy loss and the absence of significant differences in most documented pregnancy-associated disorders, women with the previous BC can be assured of the possibility of a good outcome on a subsequent pregnancy.
authors.affiliation: Faculty of Medicine, University of Paris 5, Paris, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Jacob
authors.affiliation: Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kalder
authors.affiliation: Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany.|Clara Angela Foundation Witten and Berlin, Witten, Berlin, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Arabin
authors.affiliation: Epidemiology, Real World Evidence Solutions IMS Health, Darmstädter Landstraße 108, 60598, Frankfurt am Main, Germany. kkostev@de.imshealth.com.
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000534:rehabilitation; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Breast cancer; Mode of delivery; Pregnancy; Pregnancy-associated disorders