Effects of early maternal cancer and fertility treatment on the risk of adverse birth outcomes.
Birth outcomes
Cohort study
Early onset cancer
Fertility treatment
Population-based
Survivorship
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
16
12
2021
revised:
14
03
2022
accepted:
15
03
2022
entrez:
11
4
2022
pubmed:
12
4
2022
medline:
12
4
2022
Statut:
epublish
Résumé
Early maternal cancer and fertility treatment each increase the risk for adverse birth outcomes, but the joint effect of these outcomes has not yet been reported. Thus, the aim was to assess the individual and joint effect of maternal cancer and fertility treatment on the risk for adverse birth outcomes. This population-based cohort study included 5487 live-born singletons identified in the Danish Medical Birth Register (1994-2016) of mothers with previous cancer (<40 years) recorded in the Danish Cancer Registry (1955-2014). We randomly selected 80,262 live-born singletons of mothers with no cancer <40 years matched to mothers with cancer by birth year and month. We calculated odds ratios (ORs) for preterm birth, low birth weight (LBW) (<2500 g) and small for gestational age (SGA), mean differences in birth weight in grams, and additional cases of preterm birth (gestational age<259 days) per 100,000 person-years. Multiplicative and additive interaction of maternal cancer and fertility treatment was compared with outcomes of children conceived naturally to mothers with no maternal cancer (reference group). Among 84,332 live-born singletons, increased ORs for preterm birth were observed among children born to mothers with previous cancer (1·48, 95% confidence interval [CI] 1·33-1.65) or after fertility treatment (1·43, 95% 1·28-1-61), with 22 additional cases of preterm birth among both group of children (95% CI 15-29; 95% CI 14-30). In the joint analyses, the OR for SGA for children born after fertility treatment to mothers with previous cancer was similar to that of the reference group (OR 1·02, 95% CI 0·72-1·44, Although we did not find any statistically significant additive interaction between maternal cancer and fertility treatment, children born after fertility treatment of mothers with previous cancer were at increased risk for adverse birth outcomes. Thus, pregnant women with both exposures need close follow-up during pregnancy. The Danish Cancer Society and the Danish Childhood Cancer Foundation.
Sections du résumé
Background
UNASSIGNED
Early maternal cancer and fertility treatment each increase the risk for adverse birth outcomes, but the joint effect of these outcomes has not yet been reported. Thus, the aim was to assess the individual and joint effect of maternal cancer and fertility treatment on the risk for adverse birth outcomes.
Methods
UNASSIGNED
This population-based cohort study included 5487 live-born singletons identified in the Danish Medical Birth Register (1994-2016) of mothers with previous cancer (<40 years) recorded in the Danish Cancer Registry (1955-2014). We randomly selected 80,262 live-born singletons of mothers with no cancer <40 years matched to mothers with cancer by birth year and month. We calculated odds ratios (ORs) for preterm birth, low birth weight (LBW) (<2500 g) and small for gestational age (SGA), mean differences in birth weight in grams, and additional cases of preterm birth (gestational age<259 days) per 100,000 person-years. Multiplicative and additive interaction of maternal cancer and fertility treatment was compared with outcomes of children conceived naturally to mothers with no maternal cancer (reference group).
Findings
UNASSIGNED
Among 84,332 live-born singletons, increased ORs for preterm birth were observed among children born to mothers with previous cancer (1·48, 95% confidence interval [CI] 1·33-1.65) or after fertility treatment (1·43, 95% 1·28-1-61), with 22 additional cases of preterm birth among both group of children (95% CI 15-29; 95% CI 14-30). In the joint analyses, the OR for SGA for children born after fertility treatment to mothers with previous cancer was similar to that of the reference group (OR 1·02, 95% CI 0·72-1·44,
Interpretation
UNASSIGNED
Although we did not find any statistically significant additive interaction between maternal cancer and fertility treatment, children born after fertility treatment of mothers with previous cancer were at increased risk for adverse birth outcomes. Thus, pregnant women with both exposures need close follow-up during pregnancy.
Funding
UNASSIGNED
The Danish Cancer Society and the Danish Childhood Cancer Foundation.
Identifiants
pubmed: 35399810
doi: 10.1016/j.eclinm.2022.101369
pii: S2589-5370(22)00099-2
pmc: PMC8987408
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101369Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
After finalizing her master thesis and this study, Cathrine Everhøj started as a full time employee at Danske Regioner, which is a public employer organization of the five regions in Denmark responsible for the healthcare system. Filippa Nyboe Norsker and Sofie de Fine Licht have finalized their postdoctoral work and started as full time employees at the Danish Medicines Council and AstraZeneca, respectively. None of the other authors has any conflicts of interest.
Références
PLoS Med. 2017 May 9;14(5):e1002296
pubmed: 28486495
Arch Gynecol Obstet. 2017 Feb;295(2):285-301
pubmed: 27896474
J Clin Oncol. 2018 Jul 20;36(21):2169-2180
pubmed: 29874135
Obstet Gynecol. 2004 Mar;103(3):551-63
pubmed: 14990421
Int J Cancer. 2010 Oct 1;127(7):1669-79
pubmed: 20054856
Hum Reprod. 2008 Jan;23(1):178-86
pubmed: 18024486
Eur J Cancer. 2019 Apr;111:126-137
pubmed: 30849686
Cancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2239-47
pubmed: 19661083
Ultrasound Obstet Gynecol. 2018 Jan;51(1):43-53
pubmed: 29114987
Epidemiology. 2012 Sep;23(5):733-7
pubmed: 22732385
Obstet Gynecol. 2004 Oct;104(4):720-6
pubmed: 15458892
J Natl Cancer Inst Monogr. 2005;(34):77-82
pubmed: 15784830
Fertil Steril. 2004 Dec;82(6):1514-20
pubmed: 15589852
Fertil Steril. 2013 Feb;99(2):303-10
pubmed: 23375144
Obstet Gynecol. 1996 Feb;87(2):163-8
pubmed: 8559516
J Natl Cancer Inst. 2017 Nov 1;109(11):
pubmed: 28419299
Am J Obstet Gynecol. 2017 Sep;217(3):327.e1-327.e14
pubmed: 28400311
Eur J Obstet Gynecol Reprod Biol. 2009 Oct;146(2):138-48
pubmed: 19577836
Lancet Oncol. 2016 Jul;17(7):896-906
pubmed: 27237614
Pediatr Clin North Am. 2020 Dec;67(6):1033-1049
pubmed: 33131533
Arch Pediatr Adolesc Med. 2009 Oct;163(10):879-86
pubmed: 19805705
BMJ. 2004 Jan 31;328(7434):261
pubmed: 14742347
J Clin Oncol. 2009 May 10;27(14):2374-81
pubmed: 19364956
Int J Cancer. 2017 Dec 1;141(11):2187-2196
pubmed: 28836277
Hum Reprod Update. 2012 Sep-Oct;18(5):485-503
pubmed: 22611174
Hum Reprod Update. 2020 Jun 18;26(4):514-544
pubmed: 32441298
Eur J Epidemiol. 2018 Jan;33(1):27-36
pubmed: 29349587
Hum Reprod Update. 2019 Mar 1;25(2):137-158
pubmed: 30753453
Scand J Public Health. 2011 Jul;39(7 Suppl):42-5
pubmed: 21775350
Int J Cancer. 2019 Apr 15;144(8):1954-1961
pubmed: 30350857
J Natl Cancer Inst. 2006 Oct 18;98(20):1453-61
pubmed: 17047194
JAMA. 2019 Dec 10;322(22):2203-2210
pubmed: 31821431
Int J Cancer. 2020 Feb 1;146(3):829-838
pubmed: 30989639
JAMA Oncol. 2016 Feb;2(2):193-200
pubmed: 26584448
Cancer Causes Control. 2021 Feb;32(2):169-180
pubmed: 33247354
JAMA Oncol. 2017 Aug 01;3(8):1078-1084
pubmed: 28334337
Acta Obstet Gynecol Scand. 2004 Jan;83(1):96-102
pubmed: 14678092
J Natl Cancer Inst Monogr. 2005;(34):64-8
pubmed: 15784827
Scand J Public Health. 2011 Jul;39(7 Suppl):91-4
pubmed: 21775362
PLoS One. 2014 Dec 08;9(12):e113292
pubmed: 25485774
Eur J Epidemiol. 2021 Apr;36(4):445-452
pubmed: 33796977
Am J Obstet Gynecol. 2021 Jan;224(1):3-15
pubmed: 32502557
PLoS One. 2014 Jan 08;9(1):e80398
pubmed: 24416127
Acta Paediatr. 1996 Jul;85(7):843-8
pubmed: 8819552
Int J Cancer. 2008 Dec 15;123(12):2891-8
pubmed: 18798259
Acta Obstet Gynecol Scand. 2014 Jan;93(1):64-72
pubmed: 24266525
BMC Pregnancy Childbirth. 2021 Jun 28;21(1):449
pubmed: 34182957
Fertil Steril. 2015 Apr;103(4):931-938.e2
pubmed: 25638421
Fertil Steril. 2019 Feb;111(2):372-380
pubmed: 30691634