Centre of Reproductive Medicine, Skane University Hospital, Malmö, Sweden.
Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Birth Defects Res. 2017 Feb 15;109(3):224-233. doi: 10.1002/bdra.23584.
Survival after malignancy has increased and the question of risks, including risk for congenital malformations for the offspring of these women has become important. Data on congenital malformations in such offspring are limited.
We compared congenital malformation in offspring, born 1994 to 2011 of women with a history of malignancy (at least 1 year before delivery) with all other offspring. Adjustment for confounders was mainly made by Mantel-Haenszel methodology. Data were obtained by linkage between Swedish national health registers.
We identified 71,954 (4.1%) infants with congenital malformation, of which 47,081 (2.7%) were relatively severe (roughly corresponding to major malformation). Among 7284 infants to women with a history of malignancy 204 relatively severe malformations were found (2.8%; odds ratio [OR] = 1.04; 95% confidence interval [CI], 0.91-1.20). After in vitro fertilization, the risk of a relatively severe malformation was significantly increased in women without a history of malignancy (OR = 1.31; 95% CI, 1.24-1.38) and still more in women with such a history (risk ratio = 1.85; 95% CI, 1.08-2.97). However, there were no significant differences neither, for any malformations (OR = 1.04; 95% CI, 0.92-1.16) nor for relatively severe malformations (OR = 1.04; 95% CI, 0.91-1.20), when comparing offspring only after maternal history of malignancy.
No general increase in malformation rate was found in infants born to women with a history of malignancy. A previously known increased risk after in vitro fertilization was verified and it is possible that this risk is further augmented among infants born of women with a history of malignancy. Birth Defects Research 109:224-233, 2017. © 2016 Wiley Periodicals, Inc.
恶性肿瘤患者的存活率提高，这些女性的后代发生先天畸形的风险问题变得尤为重要。此类后代发生先天畸形的数据有限。
我们比较了 1994 年至 2011 年期间患有恶性肿瘤（分娩前至少 1 年）的女性的后代与所有其他后代的先天畸形。主要通过 Mantel-Haenszel 方法进行混杂因素调整。数据通过瑞典国家健康登记处的链接获得。
我们确定了 71954 名（4.1%）患有先天畸形的婴儿，其中 47081 名（2.7%）相对严重（大致相当于重大畸形）。在 7284 名患有恶性肿瘤病史的婴儿中，发现 204 名相对严重畸形（2.8%；比值比[OR] = 1.04；95%置信区间[CI]，0.91-1.20）。在没有恶性肿瘤病史的女性中，体外受精后相对严重畸形的风险显著增加（OR = 1.31；95% CI，1.24-1.38），而在有恶性肿瘤病史的女性中风险更高（风险比[RR] = 1.85；95% CI，1.08-2.97）。然而，对于任何畸形（OR = 1.04；95% CI，0.92-1.16）或相对严重畸形（OR = 1.04；95% CI，0.91-1.20），比较仅具有母亲恶性肿瘤病史的后代时，均未发现畸形率的普遍增加。
患有恶性肿瘤的女性所生婴儿未发现畸形率普遍增加。验证了先前已知的体外受精后风险增加，并且这种风险在患有恶性肿瘤病史的女性所生婴儿中可能进一步增加。出生缺陷研究 109：224-233，2017。© 2016 威利期刊，公司。
