Cochrane Caroline, Anderson Chelsea, Mitra Sara, Green Laura, Baggett Christopher D, Mersereau Jennifer E, Getahun Darios, Kwan Marilyn L, Chao Chun R, Kushi Lawrence H, Nichols Hazel B
Department of OB/Gyn, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Womens Health (Larchmt). 2025 Jan;34(1):27-35. doi: 10.1089/jwh.2024.0064. Epub 2024 Sep 5.
To describe patterns of cancer treatment and live birth outcomes that followed a cancer diagnosis during pregnancy. The Adolescent and Young Adult (AYA) Horizon Study is an observational study evaluating outcomes in survivors of the five most common types of cancer in this age group (15-39 years old). Of the 23,629 individuals identified diagnosed with breast, lymphoma, thyroid, melanoma, or gynecological cancer in North Carolina (2000-2015) and California (2004-2016), we identified 555 live births to individuals who experienced cancer diagnosis during pregnancy. Births to individuals diagnosed with cancer during pregnancy were matched ∼1:5 on maternal age and year of delivery to live births to individuals without a cancer diagnosis ( = 2,667). Multivariable Poisson regression was used to compare birth outcomes between pregnancies affected by a cancer diagnosis and unaffected matched pregnancies. Cancer diagnosis during pregnancy was associated with an increased risk of preterm delivery (prevalence ratio [PR] 2.70; 95% confidence interval [CI] 2.24, 3.26); very preterm delivery (PR 1.74; 95% CI 1.12, 2.71); induction of labor (PR 1.48; 95% CI 1.27, 1.73); low birth weight (PR 1.97; 95% CI 1.55, 2.50); and cesarean delivery (PR 1.18; 95% CI 1.04, 1.34) but not associated with low Apgar score (PR 0.90; 95% CI 0.39, 2.06). In our sample, 41% of patients received chemotherapy, half of whom initiated chemotherapy during pregnancy, and 86% received surgery, 58% of whom had surgery during pregnancy. Of the 19% who received radiation, all received radiation treatment following pregnancy. We identified an increased risk of birth outcomes, including preterm and very preterm delivery, induction of labor, low birth weight, and cesarean delivery, to those experiencing a cancer diagnosis during pregnancy. This analysis contributes to the available evidence for those experiencing a cancer diagnosis during pregnancy.
描述孕期癌症诊断后的癌症治疗模式和活产结局。青少年和青年（AYA）地平线研究是一项观察性研究，评估该年龄组（15 - 39岁）中五种最常见癌症幸存者的结局。在北卡罗来纳州（2000 - 2015年）和加利福尼亚州（2004 - 2016年）确定的23629例被诊断患有乳腺癌、淋巴瘤、甲状腺癌、黑色素瘤或妇科癌症的个体中，我们确定了555例孕期经历癌症诊断的个体的活产情况。孕期被诊断患有癌症的个体的分娩与未患癌症个体的活产在产妇年龄和分娩年份上按约1:5进行匹配（n = 2667）。使用多变量泊松回归比较受癌症诊断影响的妊娠和未受影响的匹配妊娠之间的分娩结局。孕期癌症诊断与早产风险增加相关（患病率比[PR] 2.70；95%置信区间[CI] 2.24, 3.26）；极早产（PR 1.74；95% CI 1.12, 2.71）；引产（PR 1.48；95% CI 1.27, 1.73）；低出生体重（PR 1.97；95% CI 1.55, 2.50）；以及剖宫产（PR 1.18；95% CI 1.04, 1.34），但与阿氏评分低无关（PR 0.90；95% CI 0.39, 2.06）。在我们的样本中，41%的患者接受了化疗，其中一半在孕期开始化疗，86%接受了手术，其中58%在孕期进行了手术。在接受放疗的19%的患者中，所有患者在孕期后接受了放射治疗。我们发现孕期经历癌症诊断的个体出现包括早产和极早产、引产、低出生体重和剖宫产在内的分娩结局的风险增加。该分析为孕期经历癌症诊断的人群提供了现有证据。
