Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study

Objective - To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods - Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer...

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Main Authors: Haggar, F., Pereira, Gavin, Preen, D., D'Arcy Holman, C., Einarsdottir, K.
Format: Journal Article
Published: Public Library of Science 2014
Online Access:http://hdl.handle.net/20.500.11937/29764
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author Haggar, F.
Pereira, Gavin
Preen, D.
D'Arcy Holman, C.
Einarsdottir, K.
author_facet Haggar, F.
Pereira, Gavin
Preen, D.
D'Arcy Holman, C.
Einarsdottir, K.
author_sort Haggar, F.
building Curtin Institutional Repository
collection Online Access
description Objective - To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods - Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982–2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. Results - Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51–2.74), gestational diabetes (2.65, 2.08–3.57), pre-eclampsia (1.32, 1.04–1.87), post-partum hemorrhage (2.83, 1.92–4.67), cesarean delivery (2.62, 2.22–3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72–5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21–2.08), low birth weight (<2500 g: 1.51, 1.23–2.12), fetal growth restriction (3.27, 2.45–4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28–3.56), need for resuscitation (1.66, 1.27–2.19) or special care nursery admission (1.44, 1.13–1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors. Conclusion - Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention.
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spelling curtin-20.500.11937-297642017-09-13T15:28:01Z Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study Haggar, F. Pereira, Gavin Preen, D. D'Arcy Holman, C. Einarsdottir, K. Objective - To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods - Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982–2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. Results - Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51–2.74), gestational diabetes (2.65, 2.08–3.57), pre-eclampsia (1.32, 1.04–1.87), post-partum hemorrhage (2.83, 1.92–4.67), cesarean delivery (2.62, 2.22–3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72–5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21–2.08), low birth weight (<2500 g: 1.51, 1.23–2.12), fetal growth restriction (3.27, 2.45–4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28–3.56), need for resuscitation (1.66, 1.27–2.19) or special care nursery admission (1.44, 1.13–1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors. Conclusion - Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention. 2014 Journal Article http://hdl.handle.net/20.500.11937/29764 10.1371/journal.pone.0113292 Public Library of Science fulltext
spellingShingle Haggar, F.
Pereira, Gavin
Preen, D.
D'Arcy Holman, C.
Einarsdottir, K.
Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study
title Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study
title_full Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study
title_fullStr Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study
title_full_unstemmed Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study
title_short Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study
title_sort adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: a population-based cohort study
url http://hdl.handle.net/20.500.11937/29764