Birth Outcomes Among Adolescent and Young Adult Cancer Survivors.
OBJECTIVE
Cancer diagnosis and treatment may adversely affect reproductive outcomes among female cancer survivors.


OBJECTIVE
To compare the birth outcomes of adolescent and young adult cancer survivors (AYA [diagnosed at ages 15-39 years]) with those of women without a cancer diagnosis.


METHODS
The North Carolina Central Cancer Registry (CCR) was used to identify female AYA cancer survivors diagnosed from January 2000 to December 2013; CCR records were linked to statewide birth certificate files from January 2000 to December 2014 to identify postdiagnosis live births to AYA survivors (n = 2598). A comparison cohort of births to women without a recorded cancer diagnosis was randomly selected from birth certificate files (n = 12 990) with frequency matching on maternal age and year of delivery.


METHODS
Prevalence of preterm birth, low birth weight, small-for-gestational-age births, cesarean delivery, and low Apgar score.


RESULTS
Overall, 2598 births to AYA cancer survivors (mean [SD] maternal age, 31 [5] years) were included. Births to AYA cancer survivors had a significantly increased prevalence of preterm birth (prevalence ratio [PR], 1.52; 95% CI, 1.34-1.71), low birth weight (PR, 1.59; 95% CI, 1.38-1.83), and cesarean delivery (PR, 1.08; 95% CI, 1.01-1.14) relative to the comparison cohort of 1299. The higher prevalence of these outcomes was most concentrated among births to women diagnosed during pregnancy. Other factors associated with preterm birth and low birth weight included treatment with chemotherapy and a diagnosis of breast cancer, non-Hodgkin lymphoma, or gynecologic cancers. The prevalence of small-for-gestational-age births and low Apgar score (<7) did not differ significantly between groups.


CONCLUSIONS
Live births to AYA cancer survivors may have an increased risk of preterm birth and low birth weight, suggesting that additional surveillance of pregnancies in this population is warranted. Our findings may inform the reproductive counseling of female AYA cancer survivors.
Department of Epidemiology, University of North Carolina, Chapel Hill.
Chelsea
C
Anderson
Department of Epidemiology, University of North Carolina, Chapel Hill.
Stephanie M
SM
Engel
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill.
Jennifer E
JE
Mersereau
Department of Health Behavior, University of North Carolina, Chapel Hill.
Kristin Z
KZ
Black
Division of Hematology/Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.
William A
WA
Wood
Division of Hematology/Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.
Carey K
CK
Anders
Department of Epidemiology, University of North Carolina, Chapel Hill.
Hazel B
HB
Nichols
D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009369:Neoplasms / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult