Perinatal complications in female survivors of cancer: a systematic review and meta-analysis.
Eur J Cancer
; 111: 126-137, 2019 04.
Article
en En
| MEDLINE
| ID: mdl-30849686
ABSTRACT
BACKGROUND:
Observational studies have suggested that perinatal outcomes are worse in offspring of cancer survivors. We conducted a systematic review and meta-analysis to examine the risks of perinatal complications in female cancer survivors diagnosed before the age of 40 years.METHODS:
All published articles on pregnancy, perinatal or congenital risks in female cancer survivors were screened for eligibility. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.RESULTS:
Twenty-two studies met the inclusion criteria. Meta-analysis indicates that offspring of cancer survivors are at increased risk of prematurity (relative risk [RR] 1.56; 95% confidence interval [CI] 1.37-1.77) and low birth weight (RR 1.47; 95% CI 1.24-1.73) but not of being small for gestational age (RR 0.99; 95% CI 0.81-1.22). Cancer survivors have higher rates of elective (RR 1.38; 95% CI 1.13-1.70) and emergency caesarean section (RR 1.22; 95% CI 1.15-1.30) as well as assisted vaginal delivery (RR 1.10; 95% CI 1.02-1.18) and are at increased risk of postpartum haemorrhage (RR 1.18; 95% CI 1.02-1.36). The risk of congenital abnormalities also appears increased (RR 1.10; 95% CI 1.02-1.20), but this is likely to be an artefact of analysis. Although meta-analysis of the effects of radiotherapy was not possible for all outcomes, there was an increased risk of prematurity (RR 2.27; 95% CI 1.34-3.82) and consistent findings of low birth weight (RR 1.38-2.31). Risk of being small for gestational age was increased only after high uterine radiotherapy dosage.CONCLUSION:
The increased perinatal risks warrant a proactive approach from healthcare providers in both counselling and management of perinatal care for cancer survivors.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Complicaciones del Embarazo
/
Supervivientes de Cáncer
Tipo de estudio:
Etiology_studies
/
Guideline
/
Observational_studies
/
Systematic_reviews
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Eur J Cancer
Año:
2019
Tipo del documento:
Article
País de afiliación:
Países Bajos