Pregnancy after cancer: Does timing of conception affect infant health?
BACKGROUND The objective of this retrospective cohort study was to determine whether women who conceive soon after treatment for cancer have higher risks of adverse pregnancy outcomes. METHODS Vital records data were linked to cancer registry diagnosis and treatment information in 3 US states. Women...
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| Veröffentlicht in: | Cancer 2018-11, Vol.124 (22), p.4401-4407 |
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| creator | Hartnett, Kathleen P. Mertens, Ann C. Kramer, Michael R. Lash, Timothy L. Spencer, Jessica B. Ward, Kevin C. Howards, Penelope P. |
| description | BACKGROUND
The objective of this retrospective cohort study was to determine whether women who conceive soon after treatment for cancer have higher risks of adverse pregnancy outcomes.
METHODS
Vital records data were linked to cancer registry diagnosis and treatment information in 3 US states. Women who conceived their first pregnancy after diagnosis between ages 20 and 45 years with any invasive cancer or ductal carcinoma in situ were eligible. Log‐binomial models were used to compare risks in cancer survivors who conceived in each interval to the risks in matched comparison births to women without cancer.
RESULTS
Women who conceived ≤1 year after starting chemotherapy for any cancer had higher risks of preterm birth than comparison women (chemotherapy alone: relative risk [RR], 1.9; 95% confidence interval [CI], 1.3‐2.7; chemotherapy with radiation: RR, 2.4; 95% CI, 1.6‐3.6); women who conceived ≥1 year after starting chemotherapy without radiation or ≥2 years after chemotherapy with radiation did not. In analyses imputing the treatment end date for breast cancer survivors, those who conceived ≥1 year after finishing chemotherapy with or without radiation had no higher risks than women without cancer. The risk of preterm birth in cervical cancer survivors largely persisted but was somewhat lower in pregnancies conceived after the first year (for pregnancies conceived ≤1 year after diagnosis: RR, 3.5; 95% CI, 2.2‐5.4; for pregnancies conceived >1 year after diagnosis: RR, 2.4; 95% CI, 1.6‐3.5).
CONCLUSIONS
In women who received chemotherapy, the higher risk of preterm birth was limited to those survivors who had short intervals between treatment and conception.Cancer 2018;124:000‐000.
Cancer survivors who conceived their pregnancies more than 1 year after starting chemotherapy without radiation and 2 years after starting chemotherapy with radiation have no higher risks of preterm birth than a comparison group of women without cancer. The preterm birth risk is slightly higher in cervical cancer survivors who conceived within 1 year of diagnosis than for those who conceived >1 year after diagnosis. |
| doi_str_mv | 10.1002/cncr.31732 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7886368</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2139612812</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4482-3eba7eaedc5cb63da483f8012c0e4263501621fc1f8070d6f340a06e25c29b33</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMotlYv_gBZ8CZsnXxsdutBkVWrUFSkB28hmybtlm1Ss1ul_97UraIXT5nMPDwzvAgdY-hjAHKurPJ9ilNKdlAXwyCNATOyi7oAkMUJo68ddFDX8_BNSUL3UYcCA8oI66Lhs9dTK61aR9I02kcq1NpfRDdO11FTLko7jZyJlAvtZVM6GzijVROV1kjbRDMtq2Z2dYj2jKxqfbR9e2h8dzvO7-PR0_Ahvx7FirGMxFQXMtVST1SiCk4nkmXUZICJAs0IpwlgTrBRODRTmHBDGUjgmiSKDApKe-iy1S5XxSJYtG28rMTSlwvp18LJUvyd2HImpu5dpFnGKc-C4HQr8O5tpetGzN3K23CyIJgOOCYZJoE6aynlXV17bX42YBCbzMUmc_GVeYBPft_0g36HHADcAh9lpdf_qET-mL-00k__XIxx</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2139612812</pqid></control><display><type>article</type><title>Pregnancy after cancer: Does timing of conception affect infant health?</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Free Content</source><source>Alma/SFX Local Collection</source><creator>Hartnett, Kathleen P. ; Mertens, Ann C. ; Kramer, Michael R. ; Lash, Timothy L. ; Spencer, Jessica B. ; Ward, Kevin C. ; Howards, Penelope P.</creator><creatorcontrib>Hartnett, Kathleen P. ; Mertens, Ann C. ; Kramer, Michael R. ; Lash, Timothy L. ; Spencer, Jessica B. ; Ward, Kevin C. ; Howards, Penelope P.</creatorcontrib><description>BACKGROUND
The objective of this retrospective cohort study was to determine whether women who conceive soon after treatment for cancer have higher risks of adverse pregnancy outcomes.
METHODS
Vital records data were linked to cancer registry diagnosis and treatment information in 3 US states. Women who conceived their first pregnancy after diagnosis between ages 20 and 45 years with any invasive cancer or ductal carcinoma in situ were eligible. Log‐binomial models were used to compare risks in cancer survivors who conceived in each interval to the risks in matched comparison births to women without cancer.
RESULTS
Women who conceived ≤1 year after starting chemotherapy for any cancer had higher risks of preterm birth than comparison women (chemotherapy alone: relative risk [RR], 1.9; 95% confidence interval [CI], 1.3‐2.7; chemotherapy with radiation: RR, 2.4; 95% CI, 1.6‐3.6); women who conceived ≥1 year after starting chemotherapy without radiation or ≥2 years after chemotherapy with radiation did not. In analyses imputing the treatment end date for breast cancer survivors, those who conceived ≥1 year after finishing chemotherapy with or without radiation had no higher risks than women without cancer. The risk of preterm birth in cervical cancer survivors largely persisted but was somewhat lower in pregnancies conceived after the first year (for pregnancies conceived ≤1 year after diagnosis: RR, 3.5; 95% CI, 2.2‐5.4; for pregnancies conceived >1 year after diagnosis: RR, 2.4; 95% CI, 1.6‐3.5).
CONCLUSIONS
In women who received chemotherapy, the higher risk of preterm birth was limited to those survivors who had short intervals between treatment and conception.Cancer 2018;124:000‐000.
Cancer survivors who conceived their pregnancies more than 1 year after starting chemotherapy without radiation and 2 years after starting chemotherapy with radiation have no higher risks of preterm birth than a comparison group of women without cancer. The preterm birth risk is slightly higher in cervical cancer survivors who conceived within 1 year of diagnosis than for those who conceived >1 year after diagnosis.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.31732</identifier><identifier>PMID: 30403424</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Antineoplastic Agents - adverse effects ; Birth ; Breast cancer ; breast neoplasms ; Cancer ; Cancer Survivors ; Cancer therapies ; Cervical cancer ; Cervix ; Chemotherapy ; Childbirth & labor ; Confidence intervals ; Diagnosis ; drug therapy ; epidemiology ; Female ; Health risk assessment ; Health risks ; Humans ; Invasiveness ; Models, Statistical ; Oncology ; Population Surveillance ; Pregnancy ; Pregnancy Outcome - epidemiology ; Premature birth ; Premature Birth - epidemiology ; Premature Birth - etiology ; Radiation ; Registries ; Retrospective Studies ; Risk factors ; Survivors ; survivorship ; Time Factors ; Womens health ; Young Adult</subject><ispartof>Cancer, 2018-11, Vol.124 (22), p.4401-4407</ispartof><rights>2018 American Cancer Society</rights><rights>2018 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4482-3eba7eaedc5cb63da483f8012c0e4263501621fc1f8070d6f340a06e25c29b33</citedby><cites>FETCH-LOGICAL-c4482-3eba7eaedc5cb63da483f8012c0e4263501621fc1f8070d6f340a06e25c29b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.31732$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.31732$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30403424$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hartnett, Kathleen P.</creatorcontrib><creatorcontrib>Mertens, Ann C.</creatorcontrib><creatorcontrib>Kramer, Michael R.</creatorcontrib><creatorcontrib>Lash, Timothy L.</creatorcontrib><creatorcontrib>Spencer, Jessica B.</creatorcontrib><creatorcontrib>Ward, Kevin C.</creatorcontrib><creatorcontrib>Howards, Penelope P.</creatorcontrib><title>Pregnancy after cancer: Does timing of conception affect infant health?</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
The objective of this retrospective cohort study was to determine whether women who conceive soon after treatment for cancer have higher risks of adverse pregnancy outcomes.
METHODS
Vital records data were linked to cancer registry diagnosis and treatment information in 3 US states. Women who conceived their first pregnancy after diagnosis between ages 20 and 45 years with any invasive cancer or ductal carcinoma in situ were eligible. Log‐binomial models were used to compare risks in cancer survivors who conceived in each interval to the risks in matched comparison births to women without cancer.
RESULTS
Women who conceived ≤1 year after starting chemotherapy for any cancer had higher risks of preterm birth than comparison women (chemotherapy alone: relative risk [RR], 1.9; 95% confidence interval [CI], 1.3‐2.7; chemotherapy with radiation: RR, 2.4; 95% CI, 1.6‐3.6); women who conceived ≥1 year after starting chemotherapy without radiation or ≥2 years after chemotherapy with radiation did not. In analyses imputing the treatment end date for breast cancer survivors, those who conceived ≥1 year after finishing chemotherapy with or without radiation had no higher risks than women without cancer. The risk of preterm birth in cervical cancer survivors largely persisted but was somewhat lower in pregnancies conceived after the first year (for pregnancies conceived ≤1 year after diagnosis: RR, 3.5; 95% CI, 2.2‐5.4; for pregnancies conceived >1 year after diagnosis: RR, 2.4; 95% CI, 1.6‐3.5).
CONCLUSIONS
In women who received chemotherapy, the higher risk of preterm birth was limited to those survivors who had short intervals between treatment and conception.Cancer 2018;124:000‐000.
Cancer survivors who conceived their pregnancies more than 1 year after starting chemotherapy without radiation and 2 years after starting chemotherapy with radiation have no higher risks of preterm birth than a comparison group of women without cancer. The preterm birth risk is slightly higher in cervical cancer survivors who conceived within 1 year of diagnosis than for those who conceived >1 year after diagnosis.</description><subject>Adult</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Birth</subject><subject>Breast cancer</subject><subject>breast neoplasms</subject><subject>Cancer</subject><subject>Cancer Survivors</subject><subject>Cancer therapies</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Chemotherapy</subject><subject>Childbirth & labor</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>drug therapy</subject><subject>epidemiology</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Invasiveness</subject><subject>Models, Statistical</subject><subject>Oncology</subject><subject>Population Surveillance</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Premature birth</subject><subject>Premature Birth - epidemiology</subject><subject>Premature Birth - etiology</subject><subject>Radiation</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Survivors</subject><subject>survivorship</subject><subject>Time Factors</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlYv_gBZ8CZsnXxsdutBkVWrUFSkB28hmybtlm1Ss1ul_97UraIXT5nMPDwzvAgdY-hjAHKurPJ9ilNKdlAXwyCNATOyi7oAkMUJo68ddFDX8_BNSUL3UYcCA8oI66Lhs9dTK61aR9I02kcq1NpfRDdO11FTLko7jZyJlAvtZVM6GzijVROV1kjbRDMtq2Z2dYj2jKxqfbR9e2h8dzvO7-PR0_Ahvx7FirGMxFQXMtVST1SiCk4nkmXUZICJAs0IpwlgTrBRODRTmHBDGUjgmiSKDApKe-iy1S5XxSJYtG28rMTSlwvp18LJUvyd2HImpu5dpFnGKc-C4HQr8O5tpetGzN3K23CyIJgOOCYZJoE6aynlXV17bX42YBCbzMUmc_GVeYBPft_0g36HHADcAh9lpdf_qET-mL-00k__XIxx</recordid><startdate>20181115</startdate><enddate>20181115</enddate><creator>Hartnett, Kathleen P.</creator><creator>Mertens, Ann C.</creator><creator>Kramer, Michael R.</creator><creator>Lash, Timothy L.</creator><creator>Spencer, Jessica B.</creator><creator>Ward, Kevin C.</creator><creator>Howards, Penelope P.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>5PM</scope></search><sort><creationdate>20181115</creationdate><title>Pregnancy after cancer: Does timing of conception affect infant health?</title><author>Hartnett, Kathleen P. ; Mertens, Ann C. ; Kramer, Michael R. ; Lash, Timothy L. ; Spencer, Jessica B. ; Ward, Kevin C. ; Howards, Penelope P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4482-3eba7eaedc5cb63da483f8012c0e4263501621fc1f8070d6f340a06e25c29b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Birth</topic><topic>Breast cancer</topic><topic>breast neoplasms</topic><topic>Cancer</topic><topic>Cancer Survivors</topic><topic>Cancer therapies</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Chemotherapy</topic><topic>Childbirth & labor</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>drug therapy</topic><topic>epidemiology</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Humans</topic><topic>Invasiveness</topic><topic>Models, Statistical</topic><topic>Oncology</topic><topic>Population Surveillance</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Premature birth</topic><topic>Premature Birth - epidemiology</topic><topic>Premature Birth - etiology</topic><topic>Radiation</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Survivors</topic><topic>survivorship</topic><topic>Time Factors</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hartnett, Kathleen P.</creatorcontrib><creatorcontrib>Mertens, Ann C.</creatorcontrib><creatorcontrib>Kramer, Michael R.</creatorcontrib><creatorcontrib>Lash, Timothy L.</creatorcontrib><creatorcontrib>Spencer, Jessica B.</creatorcontrib><creatorcontrib>Ward, Kevin C.</creatorcontrib><creatorcontrib>Howards, Penelope P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hartnett, Kathleen P.</au><au>Mertens, Ann C.</au><au>Kramer, Michael R.</au><au>Lash, Timothy L.</au><au>Spencer, Jessica B.</au><au>Ward, Kevin C.</au><au>Howards, Penelope P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pregnancy after cancer: Does timing of conception affect infant health?</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2018-11-15</date><risdate>2018</risdate><volume>124</volume><issue>22</issue><spage>4401</spage><epage>4407</epage><pages>4401-4407</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>BACKGROUND
The objective of this retrospective cohort study was to determine whether women who conceive soon after treatment for cancer have higher risks of adverse pregnancy outcomes.
METHODS
Vital records data were linked to cancer registry diagnosis and treatment information in 3 US states. Women who conceived their first pregnancy after diagnosis between ages 20 and 45 years with any invasive cancer or ductal carcinoma in situ were eligible. Log‐binomial models were used to compare risks in cancer survivors who conceived in each interval to the risks in matched comparison births to women without cancer.
RESULTS
Women who conceived ≤1 year after starting chemotherapy for any cancer had higher risks of preterm birth than comparison women (chemotherapy alone: relative risk [RR], 1.9; 95% confidence interval [CI], 1.3‐2.7; chemotherapy with radiation: RR, 2.4; 95% CI, 1.6‐3.6); women who conceived ≥1 year after starting chemotherapy without radiation or ≥2 years after chemotherapy with radiation did not. In analyses imputing the treatment end date for breast cancer survivors, those who conceived ≥1 year after finishing chemotherapy with or without radiation had no higher risks than women without cancer. The risk of preterm birth in cervical cancer survivors largely persisted but was somewhat lower in pregnancies conceived after the first year (for pregnancies conceived ≤1 year after diagnosis: RR, 3.5; 95% CI, 2.2‐5.4; for pregnancies conceived >1 year after diagnosis: RR, 2.4; 95% CI, 1.6‐3.5).
CONCLUSIONS
In women who received chemotherapy, the higher risk of preterm birth was limited to those survivors who had short intervals between treatment and conception.Cancer 2018;124:000‐000.
Cancer survivors who conceived their pregnancies more than 1 year after starting chemotherapy without radiation and 2 years after starting chemotherapy with radiation have no higher risks of preterm birth than a comparison group of women without cancer. The preterm birth risk is slightly higher in cervical cancer survivors who conceived within 1 year of diagnosis than for those who conceived >1 year after diagnosis.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30403424</pmid><doi>10.1002/cncr.31732</doi><tpages>0</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Free Content; Alma/SFX Local Collection |
| subjects | Adult Antineoplastic Agents - adverse effects Birth Breast cancer breast neoplasms Cancer Cancer Survivors Cancer therapies Cervical cancer Cervix Chemotherapy Childbirth & labor Confidence intervals Diagnosis drug therapy epidemiology Female Health risk assessment Health risks Humans Invasiveness Models, Statistical Oncology Population Surveillance Pregnancy Pregnancy Outcome - epidemiology Premature birth Premature Birth - epidemiology Premature Birth - etiology Radiation Registries Retrospective Studies Risk factors Survivors survivorship Time Factors Womens health Young Adult |
| title | Pregnancy after cancer: Does timing of conception affect infant health? |
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