J Natl Cancer Inst

Prenatal chemo linked to adverse pediatric outcomes

November 20, 2024

Most children born to individuals with cancer during pregnancy generally show favorable long-term outcomes, even after in utero chemotherapy exposure. However, the high incidence of preterm birth may lead to increased rates of adverse neonatal outcomes.

Study details

Researchers identified cases using Canadian cancer registries and administrative data from Alberta, British Columbia, and Ontario, covering the period from 2003 to 2017, with follow-up extending to 2018. Outcomes assessed included severe neonatal morbidity and mortality (SNM-M), neurodevelopmental disorders and disabilities (NDDs), and pediatric complex chronic conditions (PCCC), reflecting both short- and long-term effects on children.

Findings

Among 1,150 cases of cancer diagnosed during pregnancy, 142 (12.3%) received chemo. This exposure was linked to an increased risk of SNM-M with a risk ratio of 1.67 (95% CI, 1.13-2.46). However, no significant association was found with NDD (hazard ratio [HR], 0.93, 95% CI, 0.71-1.22) or PCCC (HR, 0.96, 95% CI, 0.80-1.16). Notably, preterm births occurring before 34 weeks and 37 weeks accounted for 75.8% and 100% of the observed association between chemo and SNM-M, respectively.

Source:

Metcalfe A, et al. (2024, October 30). J Natl Cancer Inst. Cancer chemotherapy in pregnancy and adverse pediatric outcomes: a population-based cohort study. https://pubmed.ncbi.nlm.nih.gov/39475425/