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Cancer. 2018 Nov 15;124(22):4401-4407. doi: 10.1002/cncr.31732. Epub 2018 Nov 7.

Pregnancy after cancer: Does timing of conception affect infant health?

Author information

1
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
2
Department of Pediatrics, Aflac Cancer Center, Emory University School of Medicine, Atlanta, Georgia.
3
Cancer Prevention and Control Research Program, Winship Cancer Institute of Emory University, Atlanta, Georgia.
4
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
5
Georgia Center for Cancer Statistics, Georgia Cancer Registry, Atlanta, Georgia.

Abstract

BACKGROUND:

The objective of this retrospective cohort study was to determine whether women who conceive soon after treatment for cancer have higher risks of adverse pregnancy outcomes.

METHODS:

Vital records data were linked to cancer registry diagnosis and treatment information in 3 US states. Women who conceived their first pregnancy after diagnosis between ages 20 and 45 years with any invasive cancer or ductal carcinoma in situ were eligible. Log-binomial models were used to compare risks in cancer survivors who conceived in each interval to the risks in matched comparison births to women without cancer.

RESULTS:

Women who conceived ≤1 year after starting chemotherapy for any cancer had higher risks of preterm birth than comparison women (chemotherapy alone: relative risk [RR], 1.9; 95% confidence interval [CI], 1.3-2.7; chemotherapy with radiation: RR, 2.4; 95% CI, 1.6-3.6); women who conceived ≥1 year after starting chemotherapy without radiation or ≥2 years after chemotherapy with radiation did not. In analyses imputing the treatment end date for breast cancer survivors, those who conceived ≥1 year after finishing chemotherapy with or without radiation had no higher risks than women without cancer. The risk of preterm birth in cervical cancer survivors largely persisted but was somewhat lower in pregnancies conceived after the first year (for pregnancies conceived ≤1 year after diagnosis: RR, 3.5; 95% CI, 2.2-5.4; for pregnancies conceived >1 year after diagnosis: RR, 2.4; 95% CI, 1.6-3.5).

CONCLUSIONS:

In women who received chemotherapy, the higher risk of preterm birth was limited to those survivors who had short intervals between treatment and conception.Cancer 2018;124:000-000.

KEYWORDS:

breast neoplasms; drug therapy; epidemiology; pregnancy; survivorship

PMID:
30403424
DOI:
10.1002/cncr.31732

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