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Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study

Background: Female survivors of childhood cancer treated with abdominal radiotherapy who manage to conceive are at risk of delivering premature and low-birthweight offspring, but little is known about whether abdominal radiotherapy may also be associated with additional complications during pregnanc...

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Autores principales: Reulen, Raoul C., Bright, Chloe J., Winter, David L., Fidler, Miranda M., Wong, Kwok, Guha, Joyeeta, Kelly, Julie S., Frobisher, Clare, Edgar, Angela B., Skinner, Roderick, Wallace, W. Hamish B., Hawkins, Mike M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409032/
https://www.ncbi.nlm.nih.gov/pubmed/28419299
http://dx.doi.org/10.1093/jnci/djx056
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author Reulen, Raoul C.
Bright, Chloe J.
Winter, David L.
Fidler, Miranda M.
Wong, Kwok
Guha, Joyeeta
Kelly, Julie S.
Frobisher, Clare
Edgar, Angela B.
Skinner, Roderick
Wallace, W. Hamish B.
Hawkins, Mike M.
author_facet Reulen, Raoul C.
Bright, Chloe J.
Winter, David L.
Fidler, Miranda M.
Wong, Kwok
Guha, Joyeeta
Kelly, Julie S.
Frobisher, Clare
Edgar, Angela B.
Skinner, Roderick
Wallace, W. Hamish B.
Hawkins, Mike M.
author_sort Reulen, Raoul C.
collection PubMed
description Background: Female survivors of childhood cancer treated with abdominal radiotherapy who manage to conceive are at risk of delivering premature and low-birthweight offspring, but little is known about whether abdominal radiotherapy may also be associated with additional complications during pregnancy and labor. We investigated the risk of developing pregnancy and labor complications among female survivors of childhood cancer in the British Childhood Cancer Survivor Study (BCCSS). Methods: Pregnancy and labor complications were identified by linking the BCCSS cohort (n = 17 980) to the Hospital Episode Statistics (HES) for England. Relative risks (RRs) of pregnancy and labor complications were calculated by site of radiotherapy treatment (none/abdominal/cranial/other) and other cancer-related factors using log-binomial regression. All statistical tests were two-sided. Results: A total of 2783 singleton pregnancies among 1712 female survivors of childhood cancer were identified in HES. Wilms tumor survivors treated with abdominal radiotherapy were at threefold risk of hypertension complicating pregnancy (relative risk = 3.29, 95% confidence interval [CI] = 2.29 to 4.71), while all survivors treated with abdominal radiotherapy were at risk of gestational diabetes mellitus (RR = 3.35, 95% CI = 1.41 to 7.93) and anemia complicating pregnancy (RR = 2.10, 95% CI = 1.27 to 3.46) compared with survivors treated without radiotherapy. Survivors treated without radiotherapy had similar risks of pregnancy and labor complications as the general population, except survivors were more likely to opt for an elective cesarean section (RR = 1.39, 95% CI = 1.16 to 1.70). Conclusions: Treatment with abdominal radiotherapy increases the risk of developing hypertension complicating pregnancy in Wilms tumor survivors, and diabetes mellitus and anemia complicating pregnancy in all survivors. These patients may require extra vigilance during pregnancy.
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spelling pubmed-54090322017-05-03 Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study Reulen, Raoul C. Bright, Chloe J. Winter, David L. Fidler, Miranda M. Wong, Kwok Guha, Joyeeta Kelly, Julie S. Frobisher, Clare Edgar, Angela B. Skinner, Roderick Wallace, W. Hamish B. Hawkins, Mike M. J Natl Cancer Inst Article Background: Female survivors of childhood cancer treated with abdominal radiotherapy who manage to conceive are at risk of delivering premature and low-birthweight offspring, but little is known about whether abdominal radiotherapy may also be associated with additional complications during pregnancy and labor. We investigated the risk of developing pregnancy and labor complications among female survivors of childhood cancer in the British Childhood Cancer Survivor Study (BCCSS). Methods: Pregnancy and labor complications were identified by linking the BCCSS cohort (n = 17 980) to the Hospital Episode Statistics (HES) for England. Relative risks (RRs) of pregnancy and labor complications were calculated by site of radiotherapy treatment (none/abdominal/cranial/other) and other cancer-related factors using log-binomial regression. All statistical tests were two-sided. Results: A total of 2783 singleton pregnancies among 1712 female survivors of childhood cancer were identified in HES. Wilms tumor survivors treated with abdominal radiotherapy were at threefold risk of hypertension complicating pregnancy (relative risk = 3.29, 95% confidence interval [CI] = 2.29 to 4.71), while all survivors treated with abdominal radiotherapy were at risk of gestational diabetes mellitus (RR = 3.35, 95% CI = 1.41 to 7.93) and anemia complicating pregnancy (RR = 2.10, 95% CI = 1.27 to 3.46) compared with survivors treated without radiotherapy. Survivors treated without radiotherapy had similar risks of pregnancy and labor complications as the general population, except survivors were more likely to opt for an elective cesarean section (RR = 1.39, 95% CI = 1.16 to 1.70). Conclusions: Treatment with abdominal radiotherapy increases the risk of developing hypertension complicating pregnancy in Wilms tumor survivors, and diabetes mellitus and anemia complicating pregnancy in all survivors. These patients may require extra vigilance during pregnancy. Oxford University Press 2017-04-17 /pmc/articles/PMC5409032/ /pubmed/28419299 http://dx.doi.org/10.1093/jnci/djx056 Text en © The Author 2017. Published by Oxford University Press. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Reulen, Raoul C.
Bright, Chloe J.
Winter, David L.
Fidler, Miranda M.
Wong, Kwok
Guha, Joyeeta
Kelly, Julie S.
Frobisher, Clare
Edgar, Angela B.
Skinner, Roderick
Wallace, W. Hamish B.
Hawkins, Mike M.
Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
title Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
title_full Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
title_fullStr Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
title_full_unstemmed Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
title_short Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
title_sort pregnancy and labor complications in female survivors of childhood cancer: the british childhood cancer survivor study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409032/
https://www.ncbi.nlm.nih.gov/pubmed/28419299
http://dx.doi.org/10.1093/jnci/djx056
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