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既往乳腺癌对分娩方式及妊娠相关疾病的影响:对后续妊娠结局的回顾性分析

Impact of prior breast cancer on mode of delivery and pregnancy-associated disorders: a retrospective analysis of subsequent pregnancy outcomes.

作者信息

Jacob Louis, Kalder Matthias, Arabin Birgit, Kostev Karel

机构信息

Faculty of Medicine, University of Paris 5, Paris, France.

Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany.

出版信息

J Cancer Res Clin Oncol. 2017 Jun;143(6):1069-1074. doi: 10.1007/s00432-017-2352-3. Epub 2017 Feb 20.

Abstract

PURPOSE

The aim of this paper is to analyze the impact of prior breast cancer (BC) on mode of delivery and pregnancy-associated disorders.

METHODS

A database from 262 German gynecological practices including 289,712 women between the ages of 18 and 45 with documented pregnancies between 2000 and 2014 was used to search for patients with a history of BC up to 10 years prior to pregnancy. A total of 165 patients with a history of BC were found and matched with 165 patients without a history of any cancer (1:1) by age, physician, obesity, and documented referral to a fertility center up to 12 months before the index pregnancy. The impact of prior BC on the mode of delivery and pregnancy-associated disorders was analyzed using Cox regression models.

RESULTS

The mean maternal age at first visit was 34.6 years in both groups. The early and late pregnancy loss was significantly reduced (17.7 versus 29.9%, OR 0.50) and delivery of a live-born child more frequent (82.3 versus 70.1%, OR 2.00) in women who had had BC than in controls. Furthermore, preterm contractions without preterm birth were less frequent in women with BC compared to controls (9.2 versus 18.9%, OR 0.43). No significant differences were found for other pregnancy complications, such as suspected fetal growth restriction, genito-urinary infections, fetal malpresentation, gestational diabetes, pre-eclampsia, or breastfeeding issues.

CONCLUSIONS

Based on the decreased rate of early and late pregnancy loss and the absence of significant differences in most documented pregnancy-associated disorders, women with the previous BC can be assured of the possibility of a good outcome on a subsequent pregnancy.

摘要

目的

本文旨在分析既往乳腺癌(BC)对分娩方式及妊娠相关疾病的影响。

方法

利用来自262家德国妇科诊所的数据库,该数据库包含289,712名年龄在18至45岁之间、有2000年至2014年期间妊娠记录的女性,从中筛选出妊娠前10年内有BC病史的患者。共找到165例有BC病史的患者,并按年龄、医生、肥胖情况以及在本次妊娠前12个月内是否有转诊至生育中心的记录,将其与165例无任何癌症病史的患者(1:1)进行匹配。使用Cox回归模型分析既往BC对分娩方式及妊娠相关疾病的影响。

结果

两组患者首次就诊时的平均产妇年龄均为34.6岁。有BC病史的女性早期和晚期妊娠丢失率显著降低(17.7%对29.9%,OR 0.50),活产分娩频率更高(82.3%对70.1%,OR 2.00)。此外,有BC病史的女性发生无早产的早产宫缩的频率低于对照组(9.2%对18.9%,OR 0.43)。在其他妊娠并发症方面,如疑似胎儿生长受限、泌尿生殖系统感染、胎位异常、妊娠期糖尿病、子痫前期或母乳喂养问题等,未发现显著差异。

结论

基于早期和晚期妊娠丢失率降低,以及在大多数记录的妊娠相关疾病中无显著差异,既往有BC病史的女性可以确信后续妊娠有获得良好结局的可能性。

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