Maternal and Child Health Comparative Effectiveness Research Group, Department of Epidemiology and Biostatistics, College of Medicine, University of South Florida, Tampa, FL 33612, USA.
Int J Gynecol Cancer. 2013 Feb;23(2):218-26. doi: 10.1097/IGC.0b013e31827b877b.
This study aimed to evaluate the impact of maternal reproductive cancer diagnosis on fetal birth outcomes.
We conducted a retrospective population-based cohort study among women with a singleton live birth and diagnosed with reproductive cancer in the state of Florida (cases). We matched cases to cancer-free controls using selected sociodemographic and pregnancy-related clinical conditions. We applied logistic regression with correction for intracluster correlation using generalized estimating equations.
Overall, 3212 (0.21%) of pregnant women had a diagnosis of reproductive cancer. Affected women had a 24% and 33% elevated risk for low birth weight (LBW) and preterm birth (PTB) infants, respectively. Compared to their white counterparts, black women with reproductive cancer had a greater risk for LBW [odds ratio (OR), 1.83; 95% confidence interval (CI), 1.37-2.44], small for gestational age (SGA) [OR, 1.64; 95% CI, 1.23-2.17], and PTB (OR, 1.47; 95% CI, 1.12-192) infants. Black women with breast cancer demonstrated significantly higher risks of LBW [adjusted odds ratio (AOR), 2.37; 95% CI, 1.56-3.60], PTB (AOR, 1.71; 95% CI, 1.15-2.56), and SGA (AOR, 1.72; 95% CI, 1.12-2.64) when compared to women of their racial group with no reproductive cancer.
Diagnosis of reproductive cancer before or during pregnancy and within 30 days after birth is associated with adverse fetal outcomes (LBW, PTB, and SGA). These results highlight the importance of preconception and intraconception care of women with reproductive cancer diagnosis.
本研究旨在评估母亲生殖系统癌症诊断对胎儿出生结局的影响。
我们对佛罗里达州诊断出生殖系统癌症的单胎活产女性（病例）进行了一项回顾性基于人群的队列研究。我们通过选择社会人口统计学和妊娠相关临床条件，将病例与无癌症对照相匹配。我们应用了广义估计方程校正组内相关的逻辑回归。
总体而言，3212 名（0.21%）孕妇被诊断为生殖系统癌症。患有生殖系统癌症的女性所生婴儿发生低出生体重（LBW）和早产（PTB）的风险分别增加了 24%和 33%。与白人相比，患有生殖系统癌症的黑人女性发生 LBW 的风险更高[比值比（OR），1.83；95%置信区间（CI），1.37-2.44]，小于胎龄儿（SGA）[OR，1.64；95% CI，1.23-2.17]和 PTB（OR，1.47；95% CI，1.12-192）的风险更高。与无生殖系统癌症的同种族女性相比，患有乳腺癌的黑人女性发生 LBW[调整后的比值比（AOR），2.37；95% CI，1.56-3.60]、PTB（AOR，1.71；95% CI，1.15-2.56）和 SGA（AOR，1.72；95% CI，1.12-2.64）的风险显著更高。
在妊娠前、妊娠期间或分娩后 30 天内诊断出生殖系统癌症与不良胎儿结局（LBW、PTB 和 SGA）相关。这些结果强调了对患有生殖系统癌症诊断的女性进行孕前和孕中护理的重要性。
