Pediatric CA & Subsequent Pregnancy

Chemotherapy for Pediatric Cancer Does Not Affect Subsequent Pregnancy

NEW YORK Nov 06, 2002 (Reuters Health) - Female survivors of childhood cancer who were treated with chemotherapeutic agents do not have an increased risk of adverse pregnancy outcomes, according to a report in the October issue of the American Journal of Obstetrics and Gynecology.

However, pelvic irradiation does seem to increase the likelihood of having a low birth weight infant.

Dr. Daniel M. Green, of Roswell Park Cancer Institute, Buffalo, New York, and colleagues examined the effect of prior radiation therapy or chemotherapy for childhood cancer on pregnancy loss, live births, and birth weight.

They reviewed medical records and pregnancy outcomes of females in the Childhood Cancer Survivor Study (CCSS) who completed questionnaires.

The researchers note that 4029 pregnancies were reported by 1915 women. Sixty-three percent resulted in live births, 1% in stillbirths, 15% miscarriages, 17% abortions, and 3% unknown or in gestation.

"The rate of live birth was not lower and the rate of stillbirth was not higher for the patients treated with any particular chemotherapeutic agent in comparison to those who had not been treated with the agent," Dr. Green and colleagues report.

The offspring of women who received pelvic irradiation were more likely to weigh less than 2500 g at birth (RR 1.85).

There was an increased risk of miscarriage among women whose ovaries were in the radiation therapy field (relative risk [RR] 1.86) or near the field (RR 1.64). However, none of these differences were statistically significant.

The risk was not increased in women whose ovaries were shielded (RR 0.90) compared with patients who did not receive radiation therapy.

The investigators believe that the findings "are reassuring and generally support the conclusion that prior treatment with chemotherapeutic agents does not adversely affect pregnancy outcome."

However, they add that patients and their physicians should be aware of potential complications related to prior pelvic irradiation.

SOURCE:

American Journal of Obstetrics and Gynecology 2002;187:1070-1080.

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