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Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study.

Abstract Female survivors of childhood cancer treated with abdominal radiotherapy who manage to conceive are at risk of delivering premature and low-birthweight offspring, but little is known about whether abdominal radiotherapy may also be associated with additional complications during pregnancy and labor. We investigated the risk of developing pregnancy and labor complications among female survivors of childhood cancer in the British Childhood Cancer Survivor Study (BCCSS).
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title journal of the national cancer institute
Publication Year Start




PMID- 28419299
OWN - NLM
STAT- MEDLINE
DA  - 20170418
DCOM- 20170420
LR  - 20170420
IS  - 1460-2105 (Electronic)
IS  - 0027-8874 (Linking)
VI  - 109
IP  - 11
DP  - 2017 Nov 01
TI  - Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The
      British Childhood Cancer Survivor Study.
LID - 10.1093/jnci/djx056 [doi]
AB  - Background: Female survivors of childhood cancer treated with abdominal
      radiotherapy who manage to conceive are at risk of delivering premature and
      low-birthweight offspring, but little is known about whether abdominal
      radiotherapy may also be associated with additional complications during
      pregnancy and labor. We investigated the risk of developing pregnancy and labor
      complications among female survivors of childhood cancer in the British Childhood
      Cancer Survivor Study (BCCSS). Methods: Pregnancy and labor complications were
      identified by linking the BCCSS cohort (n = 17 980) to the Hospital Episode
      Statistics (HES) for England. Relative risks (RRs) of pregnancy and labor
      complications were calculated by site of radiotherapy treatment
      (none/abdominal/cranial/other) and other cancer-related factors using
      log-binomial regression. All statistical tests were two-sided. Results: A total
      of 2783 singleton pregnancies among 1712 female survivors of childhood cancer
      were identified in HES. Wilms tumor survivors treated with abdominal radiotherapy
      were at threefold risk of hypertension complicating pregnancy (relative risk =
      3.29, 95% confidence interval [CI] = 2.29 to 4.71), while all survivors treated
      with abdominal radiotherapy were at risk of gestational diabetes mellitus (RR =
      3.35, 95% CI = 1.41 to 7.93) and anemia complicating pregnancy (RR = 2.10, 95% CI
      = 1.27 to 3.46) compared with survivors treated without radiotherapy. Survivors
      treated without radiotherapy had similar risks of pregnancy and labor
      complications as the general population, except survivors were more likely to opt
      for an elective cesarean section (RR = 1.39, 95% CI = 1.16 to 1.70). Conclusions:
      Treatment with abdominal radiotherapy increases the risk of developing
      hypertension complicating pregnancy in Wilms tumor survivors, and diabetes
      mellitus and anemia complicating pregnancy in all survivors. These patients may
      require extra vigilance during pregnancy.
FAU - Reulen, Raoul C
AU  - Reulen RC
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Bright, Chloe J
AU  - Bright CJ
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Winter, David L
AU  - Winter DL
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Fidler, Miranda M
AU  - Fidler MM
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Wong, Kwok
AU  - Wong K
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Guha, Joyeeta
AU  - Guha J
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Kelly, Julie S
AU  - Kelly JS
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Frobisher, Clare
AU  - Frobisher C
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Edgar, Angela B
AU  - Edgar AB
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Skinner, Roderick
AU  - Skinner R
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Wallace, W Hamish B
AU  - Wallace WHB
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
FAU - Hawkins, Mike M
AU  - Hawkins MM
AD  - Affiliations of authors: Centre for Childhood Cancer Survivor Studies, Institute 
      of Applied Health Research, Robert Aitken Building, University of Birmingham,
      Edgbaston, Birmingham, UK (RCR, CJB, DLW, MMF, KW, JG, JSK, CF, MMH); Department 
      of Paediatric Haematology and Oncology, Royal Hospital for Sick Children,
      University of Edinburgh, Edinburgh, UK (ABE, WHBW); Department of Paediatric and 
      Adolescent Haematology and Oncology, and Children's BMT Unit, Great North
      Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK (RS).
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Natl Cancer Inst
JT  - Journal of the National Cancer Institute
JID - 7503089
SB  - IM
MH  - Anemia/epidemiology/etiology
MH  - Diabetes Mellitus/epidemiology/etiology
MH  - England
MH  - Female
MH  - Humans
MH  - Hypertension/epidemiology/etiology
MH  - Kidney Neoplasms/radiotherapy
MH  - Obstetric Labor Complications/*epidemiology/*etiology
MH  - Pregnancy
MH  - Pregnancy Complications/*epidemiology/*etiology
MH  - Radiotherapy/*adverse effects
MH  - Survivors/*statistics & numerical data
MH  - Wilms Tumor/radiotherapy
EDAT- 2017/04/19 06:00
MHDA- 2017/04/21 06:00
CRDT- 2017/04/19 06:00
PHST- 2016/10/27 [received]
PHST- 2017/03/08 [accepted]
AID - 3738120 [pii]
AID - 10.1093/jnci/djx056 [doi]
PST - ppublish
SO  - J Natl Cancer Inst. 2017 Nov 1;109(11). doi: 10.1093/jnci/djx056.

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