Petca Aida, Niculae Lucia Elena, Tocariu Raluca, Nodiți Aniela-Roxana, Petca Răzvan-Cosmin, Rotar Ioana Cristina
Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.
Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Mărăști Blvd., 050474 Bucharest, Romania.
Cancers (Basel). 2025 Jan 17;17(2):299. doi: 10.3390/cancers17020299.
Pregnancy-associated cancer (PAC) presents significant challenges for maternal and neonatal health, and yet its impact on neonatal outcomes remains poorly understood. This systematic review aims to evaluate the neonatal risks associated with PAC. A systematic search of PubMed, Embase, Scopus, and other databases was conducted up to 1 November 2024, identifying observational studies and randomized controlled trials assessing neonatal outcomes in pregnancies affected by PAC. Outcomes included preterm birth, low birthweight, macrosomia, small and large for gestational age, low Apgar score, congenital anomalies, and neonatal mortality. Eleven high-quality studies encompassing over 46 million births, including 9953 PAC-affected pregnancies, were reviewed. PAC significantly increased the risks of preterm birth (adjusted ORs ranging from 1.48 to 6.34) and low birthweight (adjusted ORs up to 5.5). Other adverse outcomes included low Apgar scores and neonatal mortality, primarily linked to prematurity. Cancer type and treatment timing influenced these outcomes, with gynecological and breast cancers posing higher risks. Neonates of mothers with PAC face increased risks of adverse outcomes, underscoring the importance of tailored, multidisciplinary management. Further prospective studies are needed to clarify the impacts of specific cancer treatments during pregnancy.
妊娠相关癌症（PAC）对孕产妇和新生儿健康构成重大挑战，但其对新生儿结局的影响仍知之甚少。本系统评价旨在评估与PAC相关的新生儿风险。截至2024年11月1日，对PubMed、Embase、Scopus和其他数据库进行了系统检索，识别评估受PAC影响的妊娠中新生儿结局的观察性研究和随机对照试验。结局包括早产、低出生体重、巨大儿、小于胎龄儿和大于胎龄儿、低阿氏评分、先天性异常和新生儿死亡。对11项高质量研究进行了综述，这些研究涵盖了超过4600万例分娩，其中包括9953例受PAC影响的妊娠。PAC显著增加了早产风险（调整后的比值比范围为1.48至6.34）和低出生体重风险（调整后的比值比高达5.5）。其他不良结局包括低阿氏评分和新生儿死亡，主要与早产有关。癌症类型和治疗时机影响这些结局，妇科和乳腺癌的风险更高。患有PAC的母亲的新生儿面临不良结局的风险增加，这凸显了量身定制的多学科管理的重要性。需要进一步的前瞻性研究来阐明孕期特定癌症治疗的影响。
