Format

Send to

Choose Destination
Am J Obstet Gynecol. 2015 Jan;212(1):47.e1-10. doi: 10.1016/j.ajog.2014.07.036. Epub 2014 Jul 25.

Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort.

Author information

1
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.
2
Memorial Sloan-Kettering Cancer Center, New York, NY.
3
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN; Division of Endocrinology, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN.
4
M. D. Anderson Cancer Center, Houston, TX.
5
Fred Hutchinson Cancer Research Center, Seattle, WA.
6
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN. Electronic address: kiri.ness@stjude.org.

Abstract

OBJECTIVE:

To evaluate associations between prepregnancy lifestyle factors, psychologic distress and adverse pregnancy outcomes among female survivors of childhood cancer.

STUDY DESIGN:

We examined pregnancies of 1192 female participants from the Childhood Cancer Survivor Study. Generalized linear models, adjusted for age at diagnosis, age at pregnancy, parity, and education were used to calculate the odds ratio (OR) and confidence interval (CI) for associations between prepregnancy inactivity, overweight or obese status, smoking status, risky drinking, psychologic distress and pregnancy outcomes. Interactions between lifestyle factors, psychologic distress, type of cancer and cancer treatment were assessed in multivariable models.

RESULTS:

The median age of study participants at the beginning of pregnancy was 28 years (range, 14-45). Among 1858 reported pregnancies, there were 1300 singleton live births (310 were preterm), 21 stillbirths, 397 miscarriages, and 140 medical abortions. Prepregnancy physical inactivity, risky drinking, distress, and depression were not associated with any pregnancy outcomes. Compared with those who had never smoked, survivors with >5 pack-years smoking history had a higher risk for miscarriage among those treated with >2.5 Gray (Gy) uterine radiation (OR, 53.9; 95% CI, 2.2-1326.1) than among those treated with ≤2.5 Gy uterine radiation (OR, 1.9; 95% CI, 1.2-3.0). There was a significant interaction between smoking and uterine radiation (Pinteraction = .01).

CONCLUSION:

Although most lifestyle factors and psychologic distress were not predictive of adverse pregnancy outcomes, the risk for miscarriage was significantly increased among survivors exposed to >2.5 Gy uterine radiation who had a history of smoking.

KEYWORDS:

childhood cancer survivors; lifestyle; pregnancy; smoking; uterine radiation

PMID:
25068563
PMCID:
PMC4275351
DOI:
10.1016/j.ajog.2014.07.036
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center