Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, Room Hs-422K, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Hum Reprod. 2010 May;25(5):1206-12. doi: 10.1093/humrep/deq029. Epub 2010 Feb 19.
The number of childhood cancer survivors has dramatically increased and consequently, an increasing number of survivors may now wish to conceive. Recently, several studies have described that previous treatment with abdominal radiotherapy may increase the risk of adverse pregnancy outcome.
We conducted a retrospective single centre cohort study of childhood cancer survivors with a singleton live birth between January 2000 and December 2005. Pregnancy outcome was compared with data from the Netherlands Perinatal Registry, a nationwide database of pregnancy outcome parameters of all births in the Netherlands registered by midwives, obstetricians and paediatricians.
Data were available on 40 survivors and 9031 controls. Median age at diagnosis was 6.9 years (range 0.1-16.8 years). The median interval between diagnosis and date of delivery was 21.6 years (range 7.4-36.1 years). In the whole cohort, pregnancy outcome was not different between survivors and controls. However, survivors treated with abdominal radiotherapy delivered preterm and had post-partum haemorrhage (mean gestational age in survivors = 34.9 versus 39.2 weeks in controls, P = 0.001; 33% in survivors versus 5% in controls, P = 0.007, respectively). The offspring of survivors had normal birthweight after adjustment for gestational age (mean birthweight in offspring of survivors 2503 versus 1985 g; P = 0.22).
Childhood cancer survivors irradiated to the abdomen have an earlier delivery and higher incidence of post-partum haemorrhage. This stresses the need for close monitoring of the delivery, including inpatient perinatal care, in this group of childhood cancer survivors.
儿童癌症幸存者的数量显著增加，因此，越来越多的幸存者可能希望怀孕。最近，有几项研究表明，以前接受腹部放疗可能会增加不良妊娠结局的风险。
我们进行了一项回顾性单中心队列研究，纳入了 2000 年 1 月至 2005 年 12 月期间患有单胎活产的儿童癌症幸存者。将妊娠结局与荷兰围产期登记处的数据进行比较，荷兰围产期登记处是一个全国性数据库，记录了荷兰所有产妇的妊娠结局参数，由助产士、产科医生和儿科医生登记。
40 名幸存者和 9031 名对照者的数据可用。诊断时的中位年龄为 6.9 岁（范围 0.1-16.8 岁）。诊断与分娩日期之间的中位间隔为 21.6 年（范围 7.4-36.1 年）。在整个队列中，幸存者和对照者的妊娠结局没有差异。然而，接受腹部放疗的幸存者早产并出现产后出血（幸存者的平均孕龄为 34.9 周，对照组为 39.2 周，P=0.001；幸存者中 33%，对照组中 5%，P=0.007）。调整孕龄后，幸存者后代的出生体重正常（幸存者后代的平均出生体重为 2503 克，对照组为 1985 克；P=0.22）。
腹部接受放疗的儿童癌症幸存者分娩较早，产后出血发生率较高。这强调了需要对这组儿童癌症幸存者进行密切的分娩监测，包括住院围产期护理。
