青少年和青年癌症患者的生殖健康结局：一项系统评价与荟萃分析
Reproductive Health Outcomes among Adolescent and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis.
作者信息
Oveisi Niki, Cheng Vicki, Ellis Ursula, Peacock Stuart, McTaggart-Cowan Helen, Brotto Lori A, Loree Jonathan, Hanley Gillian E, Gill Sharlene, Rayar Meera, Srikanthan Amirrtha, De Vera Mary A
机构信息
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Collaboration for Outcomes Research and Evaluation, Vancouver, BC V6T 1Z3, Canada.
出版信息
Cancers (Basel). 2023 Mar 10;15(6):1707. doi: 10.3390/cancers15061707.
BACKGROUND
This systematic review and meta-analysis (SRMA) aimed to synthesize the current literature on the impacts of adolescent and young adult (AYA, ages 15-39 years) cancer on reproductive health outcomes.
METHODS
EMBASE and Medline were searched from 1 January 2000 to 26 January 2022 for observational studies that included individuals with AYA cancer and controls which evaluated reproductive health outcomes. We used random effects models and 95% confidence intervals to obtain pooled measures of associations between AYA cancer, cancer treatment, and reproductive health outcomes.
RESULTS
The search identified 8625 articles; 21 were included. 62 reproductive outcomes were assessed and classified according to a sex-based framework as fetal/neonatal (n = 26), maternal (n = 11), fetal/neonatal-maternal (n = 23), and maternal-paternal (n = 2). Meta-analyses of crude estimates showed significant associations between AYA cancer and outcomes including preterm birth (pooled odds ratio [pOR] 1.31; 95% CI: 1.22, 1.42), gestational diabetes (pOR 1.43; 95% CI: 1.03, 1.99), and fertility treatment (pOR 2.66; 95% CI 1.71, 4.11). We also found higher odds of preterm birth (pOR 1.65; 95% CI: 1.21, 2.26) and low APGAR score at birth (pOR 2.03; 95% CI: 1.32, 3.13) among AYA cancer patients who received radiation compared to controls.
CONCLUSIONS
Our SRMA quantified impacts of AYA cancers and treatments on several reproductive health outcomes.
背景
本系统评价与荟萃分析旨在综合当前关于青少年及青年（15至39岁）癌症对生殖健康结局影响的文献。
方法
检索了EMBASE和Medline数据库，时间范围为2000年1月1日至2022年1月26日，以查找包含青少年及青年癌症患者和对照的观察性研究，这些研究评估了生殖健康结局。我们使用随机效应模型和95%置信区间来获得青少年及青年癌症、癌症治疗与生殖健康结局之间关联的合并测量值。
结果
检索共识别出8625篇文章；纳入了21篇。评估了62种生殖结局，并根据基于性别的框架分为胎儿/新生儿（n = 26）、母体（n = 11）、胎儿/新生儿 - 母体（n = 23）和母体 - 父体（n = 2）。粗估计值的荟萃分析显示，青少年及青年癌症与早产（合并比值比[pOR] 1.31；95%置信区间：1.22，1.42）、妊娠期糖尿病（pOR 1.43；95%置信区间：1.03，1.99）和生育治疗（pOR 2.66；95%置信区间1.71，4.11）等结局之间存在显著关联。我们还发现，与对照组相比，接受放疗的青少年及青年癌症患者早产的几率更高（pOR 1.65；95%置信区间：1.21，2.26），出生时阿氏评分低的几率更高（pOR 2.03；95%置信区间：1.32，3.13）。
结论
我们的系统评价与荟萃分析量化了青少年及青年癌症及其治疗对多种生殖健康结局的影响。
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