乳腺癌诊断后的不良产科结局：德国的一项观察性数据库研究

Adverse Obstetric Outcomes after Breast Cancer Diagnosis: An Observational Database Study in Germany.

作者信息

Scholz Anna Sophie, von Au Alexandra, Gutsfeld Raphael, Dijkstra Tjeerd Maarten Hein, Dannehl Dominik, Hassdenteufel Kathrin, Hahn Markus, Hawighorst-Knapstein Sabine, Chaudhuri Ariane, Bauer Armin, Wallwiener Markus, Brucker Sara Yvonne, Hartkopf Andreas Daniel, Wallwiener Stephanie

机构信息

Department of Gynecology and Obstetrics, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Department of Women's Health, University Hospital Tuebingen, 72076 Tuebingen, Germany.

出版信息

Cancers (Basel). 2024 Sep 22;16(18):3230. doi: 10.3390/cancers16183230.

DOI:10.3390/cancers16183230

PMID:39335201

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11430513/

Abstract

BACKGROUND/OBJECTIVES: Breast cancer may negatively affect later pregnancy and childbirth. We aimed to analyze the impact of previous breast cancer on obstetric outcomes in postdiagnosis pregnancies.

METHODS

Insurance claims data in Southern Germany were used to identify breast cancer (BC) survivors with at least one subsequent delivery after cancer diagnosis between 2010 and 2020. In total, 74 BC survivors were compared to 222 age-matched controls with frequency matching on their age at their postdiagnosis delivery.

RESULTS

Endocrine therapy was associated with a significantly lower probability of birth compared to BC survivors without endocrine therapy (HR 0.36; 95% CI 0.18-0.53; < 0.0001). The risks of preterm birth, low birth weight (LBW), gestational diabetes, hypertensive disorders, and cesarean section were not significantly increased among BC survivors compared to healthy controls. BC survivors were at an increased risk for a small-for-gestational-age (SGA) fetus (OR 3.24; 95% CI 1.17-8.97, = 0.03). Delivery in less than 2 years after diagnosis increased the risk for SGA (OR 5.73; 95% CI 1.37-24.02, = 0.03) and LBW (OR 4.57; 95% CI 1.32-15.87, = 0.02).

CONCLUSIONS

Our findings are encouraging regarding the risks of preterm delivery, gestational diabetes, hypertensive disorders, and cesarean section to women who consider pregnancy after BC. Delivery in less than 2 years after diagnosis was associated with an increased risk for SGA and LBW.

摘要

背景/目的：乳腺癌可能会对日后的妊娠和分娩产生负面影响。我们旨在分析既往乳腺癌对诊断后妊娠的产科结局的影响。

方法

利用德国南部的保险理赔数据，识别出2010年至2020年间在癌症诊断后至少有一次分娩的乳腺癌（BC）幸存者。总共将74名BC幸存者与222名年龄匹配的对照者进行比较，对照者在诊断后分娩时的年龄进行了频率匹配。

结果

与未接受内分泌治疗的BC幸存者相比，内分泌治疗与分娩概率显著降低相关（风险比[HR]0.36；95%置信区间[CI]0.18 - 0.53；P < 0.0001）。与健康对照者相比，BC幸存者发生早产、低出生体重（LBW）、妊娠期糖尿病、高血压疾病和剖宫产的风险没有显著增加。BC幸存者出现小于胎龄（SGA）胎儿的风险增加（比值比[OR]3.24；95%CI 1.17 - 8.97，P = 0.03）。诊断后不到2年分娩会增加SGA（OR 5.73；95%CI 1.37 - 24.02，P = 0.03）和LBW（OR 4.５7；95%CI 1.32 - 15.87，P = 0.02）的风险。