Babies born to adult survivors of childhood cancers are as healthy as those born to adults without a history of cancer, but survivors have a higher risk of severe complications during pregnancy, researchers reported in the Journal of the National Cancer Institute.
Researchers compared obstetric and perinatal outcomes in 4,062 females who had been diagnosed with cancer before age 21 to 20,308 females without a cancer diagnosis. By age 30, 22.3% of survivors and 26.6% of comparisons had a recorded pregnancy, and survivors and comparisons had a similar rate of carrying a pregnancy to 20 weeks or longer. Brain tumors, alkylating chemotherapy, cranial radiation, and hematopoietic stem cell transplantation were associated with a lower likelihood of pregnancy.
Survivors had a higher relative risk of severe maternal morbidity and cardiac morbidity. Relative risk for preterm birth was also higher among survivors (9%) than comparisons (6%), particularly those who were treated with hematopoietic stem cell transplantation.
The increased risk of complications underscores the need for detailed survivorship care plans to keep all members of a patient’s current and future healthcare team informed about their cancer history so that obstetricians are aware of a need to evaluate them for referrals to high-risk care.
“The message here is largely positive,” the researchers said. “Women who have a history of childhood cancer have a really good chance of getting pregnant, and most of them are quite fine through the pregnancy. But it’s important for the people caring for them to know about these risks.”