Stillbirth and neonatal death among female cancer survivors: A national cohort study. Issue 5 (5th May 2016)

• Record Type: Journal Article
• Authors: Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina
• Is Part Of: International journal of cancer. Volume 139:Issue 5(2016:Sep. 01)
• Page Start: 1046
• Page End: 1052
• Publication Date: 2016-05-05
• Subjects: stillbirth -- neonatal death -- epidemiology -- cancer survivor; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.30156
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : The number of cancer survivors continues to increase worldwide. Many of these survivors have had children of their own. It is less well‐known whether radiation therapy or chemotherapy could affect the risk of stillbirth and neonatal death for these children. To explore this research questions, we identified all women diagnosed with cancer between 1958 and 2012 from the Swedish Cancer Register and they were further linked to the Swedish Medical Birth Register to identify their subsequent child birth between 1973 and 2012. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between stillbirth and neonatal death and maternal cancer diagnosis. As compared to the children without maternal cancer, the risk of stillbirth was significantly higher among children of female cancer survivors born within three years after cancer diagnosis with an OR of 1.92 (95% CI 1.03–3.57). The incidence of neonatal death did not show a significant change. For women with more than one pregnancy after cancer diagnosis, the risk of stillbirth and neonatal death was lower for the second child birth compared to the first child birth. Our study suggested that the risk of stillbirth was negatively associated with the time after cancer diagnosis, providing evidence that the adverse effect associated with cancer treatment may diminish with time. Abstract : What's New? Increasing numbers of people are surviving cancer, and many of those survivors are young or of child‐bearing age and want to have children. However, little is known about the consequences of cancer treatments, particularly radiotherapy or chemotherapy, on pregnancy outcomes. Here, the authors identify a window of time—within three years after maternal cancer diagnosis—when risk of stillbirth is increased for women who survived cancer and subsequently became pregnant. The risk of stillbirth dropped significantly for later, additional childbirths, indicating a weakening of adverse effects over time.