Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
BJOG. 2012 Dec;119(13):1572-82. doi: 10.1111/j.1471-0528.2012.03475.x. Epub 2012 Sep 5.
To determine trends in pregnancy-associated cancer and associations between maternal cancer and pregnancy outcomes.
Population-based cohort study.
New South Wales, Australia, 1994-2008.
A total of 781 907 women and their 1 309 501 maternities.
Cancer and maternal information were obtained from linked cancer registry, birth and hospital records for the entire population. Generalised estimating equations with a logit link were used to examine associations between cancer risk factors and pregnancy outcomes.
Incidence of pregnancy-associated cancer (diagnosis during pregnancy or within 12 months of delivery), maternal morbidities, preterm birth, and small- and large-for-gestational-age (LGA).
A total of 1798 new cancer diagnoses were identified, including 499 during pregnancy and 1299 postpartum. From 1994 to 2007, the crude incidence rate of pregnancy-associated cancer increased from 112.3 to 191.5 per 100 000 maternities (P < 0.001), and only 14% of the increase was explained by increasing maternal age. Cancer diagnosis was more common than expected in women aged 15-44 years (observed-to-expected ratio 1.49; 95% CI 1.42-1.56). Cancers were predominantly melanoma (33.3%) and breast cancer (21.0%). Women with cancer diagnosed during pregnancy had high rates of labour induction (28.5%), caesarean section (40.0%) and planned preterm birth (19.7%). Novel findings included a cancer association with multiple pregnancies (adjusted odds ratio 1.52, 95% CI 1.13-2.05) and LGA (aOR 1.47, 95% CI 1.14-1.89).
Pregnancy-associated cancers have increased, and this increase is only partially explained by increasing maternal age. Pregnancy increases women's interaction with health services and the possibility for diagnosis, but may also influence tumour growth.
确定妊娠相关癌症的趋势以及母体癌症与妊娠结局之间的关系。
基于人群的队列研究。
澳大利亚新南威尔士州，1994-2008 年。
共有 781907 名妇女及其 1309501 次分娩。
癌症和产妇信息来自癌症登记处、分娩和医院记录的链接，为整个人群提供信息。使用对数链接的广义估计方程来研究癌症风险因素与妊娠结局之间的关系。
妊娠相关癌症（妊娠期间或分娩后 12 个月内诊断）、产妇合并症、早产和小于胎龄儿（SGA）和大于胎龄儿（LGA）的发病率。
共发现 1798 例新癌症诊断，其中 499 例在妊娠期间，1299 例在产后。从 1994 年到 2007 年，妊娠相关癌症的粗发病率从 112.3/10 万增加到 191.5/10 万（P < 0.001），仅 14%的增加归因于产妇年龄的增加。在 15-44 岁的女性中，癌症诊断的发生率高于预期（观察到的与预期的比值为 1.49；95%CI 1.42-1.56）。癌症主要是黑色素瘤（33.3%）和乳腺癌（21.0%）。在妊娠期间诊断出癌症的妇女中，引产率高（28.5%），剖宫产率（40.0%）和计划早产率（19.7%）高。新发现包括癌症与多胎妊娠（调整后的优势比 1.52，95%CI 1.13-2.05）和 LGA（aOR 1.47，95%CI 1.14-1.89）之间存在关联。
妊娠相关癌症的发病率有所增加，而这一增加仅部分归因于产妇年龄的增加。妊娠增加了妇女与卫生服务的互动和诊断的可能性，但也可能影响肿瘤的生长。
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