J Cancer 2019; 10(23):5727-5734. doi:10.7150/jca.33746

Research Paper

Maternal and neonatal outcomes of cancer during pregnancy: a multi-center observational study

Zhang YP1*, Duan J2*, Zhu XW3, Li J4, Shi Y5✉

1. Department of Pediatrics, The Second Affiliated Hospital of the Third Military Medical University, Chongqing, 400037 China.
2. Department of Pediatrics, the People's Hospital of Shapingba District, Chongqing, 400030, China.
3. Department of Neonatology, Jiulongpo People's Hospital, Chongqing, 400024, China
4. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400014, China.
5. China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, P.R China.
*co-first author, equal contributions to the present study.

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Citation:
YP Z, J D, XW Z, J L, Y S. Maternal and neonatal outcomes of cancer during pregnancy: a multi-center observational study. J Cancer 2019; 10(23):5727-5734. doi:10.7150/jca.33746. Available from http://www.jcancer.org/v10p5727.htm

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Abstract

Cancer during pregnancy has increased because of the increased maternal age at the time of the first pregnancy and/or second child policy in China. The main purpose of the study is to report the existing data concerning the maternal and children's outcomes in pregnant women complicating cancer. In this multi-center, prospective cohort study, we compared women diagnosed with cancer during pregnancy and their children with matched women without cancer diagnoses. The primary outcomes were maternal and children's mortalities, as well as the Ages and Stages Questionnaires-3(ASQ) of children. A total of 80,524 pregnant women were screened. Of whom 83(0.1%) were diagnosed with cancer during pregnancy. Death occurs in 42.2% (35/83) women during follow-up. During pregnancy, 24 women terminated pregnancy before 28 weeks and among this 8(33.3%) died. Ten women received chemotherapy and 49 did not receive chemotherapy. Compared with the matched controls, there were less incidences of premature rupture of membrane (5.1% vs 35.6%, P=0.000) and more caesarean rates (84.7% vs 52.5%, P=0.001) and with higher pregnancy order (2.7±1.7 vs 2.0±1.0, P=0.007) in pregnant women with cancer. These women also had increased mortality compared with control group (45.8% vs 1.7%, P=0.000). Women who received chemotherapy had a statistically significant lower mortality rate when compared to the non-chemotherapy group (1:9 vs 26:23, P=0.016). However, there were no differences found in mortality of children and ASQ assessment between two groups. Chemotherapy may result in reduced mortality of women diagnosed with cancer during pregnancy, without affecting the mortality of children and ASQ-associated development.

Keywords: pregnancy, complicating cancer