Department of Epidemiology, University of Iowa, Iowa City, IA, USA.
Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6115-6123. doi: 10.1080/14767058.2021.1907332. Epub 2021 Apr 8.
Leukemia and lymphoma are top cancers affecting children, adolescents and young adults with high five-year survival rates. Late effects of these cancers are a concern in reproductive-age patients, including pregnancy outcomes such as preterm birth. Our study aimed to evaluate whether diagnosis of leukemia or lymphoma prior to pregnancy was associated with preterm birth (<37 weeks gestation).
We conducted a cross-sectional study using a population-based dataset from California with linked birth certificates to hospital discharge records and an Iowa-based sample that linked birth certificates to Surveillance, Epidemiology, and End Results (SEER) cancer registry data. Preterm birth was defined using birth certificates. We ascertained history of leukemia and lymphoma using discharge diagnosis data in California and SEER registry in Iowa.
Prevalence of preterm birth in California and Iowa was 14.6% and 12.0%, respectively, in women with a history of leukemia/lymphoma compared to 7.8% and 8.2%, respectively, in women without a cancer history. After adjusting for maternal age, race, education, smoking, and plurality, Women with history of leukemia/lymphoma were at an increased risk of having a preterm birth in California (odds ratio (OR) 1.89; 95% confidence interval (CI) 1.56-2.28) and Iowa (OR 1.61; 95% CI 1.10-2.37) compared to those with no cancer history.
In both California and Iowa, women with a history of leukemia or lymphoma were at increased risk for preterm birth. This suggests the importance of counseling with a history of leukemia/lymphoma prior to pregnancy and increased monitoring of women during pregnancy.
白血病和淋巴瘤是影响儿童、青少年和青年的主要癌症，五年生存率较高。这些癌症的晚期影响是生殖年龄患者的一个关注点，包括早产等妊娠结局。我们的研究旨在评估妊娠前诊断白血病或淋巴瘤是否与早产（<37 周妊娠）有关。
我们使用加利福尼亚州基于人群的数据集和与医院出院记录相关联的出生证明，以及爱荷华州基于样本的与监测、流行病学和最终结果（SEER）癌症登记处数据相关联的出生证明，进行了一项横断面研究。早产通过出生证明确定。我们使用加利福尼亚州的出院诊断数据和爱荷华州的 SEER 登记处确定白血病和淋巴瘤的病史。
在加利福尼亚州和爱荷华州，有白血病/淋巴瘤病史的女性早产率分别为 14.6%和 12.0%，而无癌症病史的女性早产率分别为 7.8%和 8.2%。在校正了母亲年龄、种族、教育程度、吸烟和多胎后，与无癌症病史的女性相比，有白血病/淋巴瘤病史的女性在加利福尼亚州（比值比 (OR) 1.89；95%置信区间 (CI) 1.56-2.28）和爱荷华州（OR 1.61；95% CI 1.10-2.37）发生早产的风险增加。
在加利福尼亚州和爱荷华州，有白血病或淋巴瘤病史的女性发生早产的风险增加。这表明在妊娠前对有白血病/淋巴瘤病史的患者进行咨询以及在妊娠期间对女性进行加强监测非常重要。
