Sorokine Avigayil, Czuzoj-Shulman Nicholas, Abenhaim Haim Arie
Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Pavilion H, Room 325, 5790 Cote-des-Neiges Road, Montreal, H3S 1Y9, Canada.
Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, QC, Canada.
Arch Gynecol Obstet. 2023 Mar;307(3):747-753. doi: 10.1007/s00404-022-06566-5. Epub 2022 May 7.
With improvement in cancer care and fertility preservation, increasing numbers of cancer survivors are requiring obstetrical care. The objective of our study was to evaluate the effect of history of chemotherapy exposure on maternal and neonatal outcomes.
A retrospective population-based cohort study was conducted using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) to obtain data on maternal and newborn outcomes in a cohort of births occurring between the years 2006 and 2015. The annual and overall prevalence of chemotherapy exposure was calculated among pregnant women, and multivariate logistic regression models were used to estimate the effect of history of exposure to chemotherapy on the risk of adverse maternal and newborn outcomes.
Of 7,907,139 birth admissions, 613 had a history of chemotherapy exposure for an overall incidence of 7.75 per 100,000 admissions. The prevalence of chemotherapy exposure in pregnancy increased during the study period (P < 0.001). Women with a history of chemotherapy were more likely to suffer from obstetric and medical complications including pre-eclampsia, chorioamnionitis, postpartum hemorrhage, and venous thromboembolism as well as an increased risk in overall mortality (OR 9.39, 95% CI 1.31-67.32). No differences were observed in the incidence of adverse neonatal outcomes, including stillbirth, intra-uterine growth restriction, or preterm birth.
Women with history of chemotherapy have higher incidence of pregnancy complications and maternal death, with no differences in fetal or newborn outcomes.
随着癌症治疗和生育力保存技术的进步，越来越多的癌症幸存者需要产科护理。我们研究的目的是评估化疗暴露史对孕产妇和新生儿结局的影响。
利用医疗成本与利用项目全国住院患者样本（HCUP-NIS）进行了一项基于人群的回顾性队列研究，以获取2006年至2015年间出生队列中孕产妇和新生儿结局的数据。计算孕妇中化疗暴露的年度和总体患病率，并使用多变量逻辑回归模型估计化疗暴露史对孕产妇和新生儿不良结局风险的影响。
在7907139例出生入院病例中，613例有化疗暴露史，总体发病率为每100000例入院7.75例。研究期间，孕期化疗暴露的患病率有所增加（P＜0.001）。有化疗史的女性更易患产科和内科并发症，包括子痫前期、绒毛膜羊膜炎、产后出血和静脉血栓栓塞，总体死亡率风险也增加（比值比9.39，95%可信区间1.31-67.32）。在不良新生儿结局的发生率方面未观察到差异，包括死产、宫内生长受限或早产。
有化疗史的女性妊娠并发症和孕产妇死亡的发生率较高，胎儿或新生儿结局无差异。
