Adverse obstetric outcomes among female childhood and adolescent cancer survivors in Sweden: A population-based matched cohort study.
Adolescent
Adult
Anal Canal
/ injuries
Cancer Survivors
/ statistics & numerical data
Case-Control Studies
Cesarean Section
/ statistics & numerical data
Child
Child, Preschool
Clitoris
/ injuries
Delivery, Obstetric
/ statistics & numerical data
Dystocia
/ epidemiology
Female
Humans
Labor Presentation
Labor, Induced
/ statistics & numerical data
Lacerations
/ epidemiology
Pre-Eclampsia
/ epidemiology
Pregnancy
Registries
Sweden
/ epidemiology
Vacuum Extraction, Obstetrical
/ statistics & numerical data
Young Adult
adolescence
cancer survivors
cesarean section
childhood
delivery, obstetric
labor, induced
preeclampsia
pregnancy, high-risk
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
07
07
2019
accepted:
17
07
2019
pubmed:
23
7
2019
medline:
31
3
2020
entrez:
23
7
2019
Statut:
ppublish
Résumé
Cancer treatment during childhood may lead to late adverse effects, such as reduced musculoskeletal development or vascular, endocrine and pulmonary dysfunction, which in turn may have an adverse effect on later pregnancy and childbirth. The aim of the present study was to investigate pregnancy and obstetric outcomes as well as the offspring's health among childhood and adolescent female cancer survivors. This register-based study included all women born between 1973 and 1977 diagnosed with cancer in childhood or adolescence (age <21), as well as an age-matched comparison group. A total of 278 female cancer survivors with their first childbirth were included in the study, together with 829 age-matched individuals from the general population. Logistic regression and analysis of variance were used to investigate associations between having been treated for cancer and the outcome variables, adjusting for maternal age, nicotine use and comorbidity. Survivors were more likely to have preeclampsia (adjusted odds ratio [aOR] 3.46, 95% confidence interval [CI] 1.58 to 7.56), undergo induction of labor (aOR 1.66, 95% CI 1.05 to 2.62), suffer labor dystocia (primary labor dystocia aOR 3.54, 95% CI 1.51 to 8.34 and secondary labor dystocia aOR 2.43, 95% CI 1.37 to 4.31), malpresentation of fetus (aOR 2.02, 95% CI 1.12 to 3.65) and imminent fetal asphyxia (aOR 2.55, 95% CI 1.49 to 4.39). In addition, deliveries among survivors were more likely to end with vacuum extraction (aOR 2.53, 95% CI 1.44 to 4.47), with higher risk of clitoral lacerations (aOR 2.18, 95% CI 1.47 to 3.23) and anal sphincter injury (aOR 2.76, 95% CI 1.14 to 6.70) and emergency cesarean section (aOR 2.34 95% CI 1.39 to 3.95). Survivors used pain-reliving methods to a higher extent compared with the comparison group. There was no increased risk of neonate diagnoses and malformations. The results showed that survivors who had been diagnosed with cancer when they were younger than 14 had an increased risk of adverse obstetric outcomes. The study demonstrates increased risk of pregnancy and childbirth complications among childhood and adolescent cancer survivors. There is a need to optimize perinatal care, especially among survivors who were younger than 14 at time of diagnosis.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1603-1611Informations de copyright
© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.
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