J Gynecol Oncol.  2024 Nov;35(6):e74. 10.3802/jgo.2024.35.e74.

Influence of cancer in pregnancy on obstetric and neonatal outcomes: an observational retrospective cohort study

• Huang X
• Zhang C
• Zhu J
• Li Y
• Tang J

• KMID: 2564970
• DOI: http://doi.org/10.3802/jgo.2024.35.e74

Abstract

Objective
The study aimed to review the oncological characteristics and treatment of pregnancy-associated cancers and analyze the obstetric and neonatal outcomes to provide evidence-based recommendations for reproductive function preservation, oncological treatment, and obstetric management.
Methods
We conducted an observational retrospective cohort study among pregnant patients with cancer in 7 Chinese tertiary A hospitals from 2003 to 2021. We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and χ 2 tests to explore the effects of cancer type/treatment.
Results
Of 204 women, 17% terminated their pregnancies; 59% received pre-delivery treatment. Every 6 years, the rates of pregnancy termination (relative risk [RR]=0.48; 95% confidence interval [CI]=0.35–0.67) and iatrogenic preterm births (RR=0.73; 95% CI=0.54–0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR=1.87; 95% CI=1.31–2.67). Maternal systemic diseases were related to small-for-gestational-age infants (odds ratio [OR]=12.02; 95% CI=1.82–79.43). Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR=1.87; 95% CI=1.42–2.46; p<0.05). Thyroid (OR=0.36; 95% CI=0.22–0.57) and ovarian cancer (OR=0.70; 95% CI=0.50–0.98) were associated with fewer cesarean sections. Thyroid cancer was associated with fetal growth restriction (OR=5.21; 95% CI=1.21–22.55).
Conclusion
Rates of pregnancy termination in cancer declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes.

Keyword

Retrospective Studies; Cohort Studies; Pregnancy Complications; Neoplasms; Antineoplastic Agents