Obstetrical and infant outcomes among women with neoplasms during pregnancy
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One in 1,000 pregnancies is complicated by malignancies. Prevalence is greater for benign neoplasms. Adverse outcomes among women with malignancies have been reported. Less is known of postpartum outcomes for infants, or outcomes among women with benign neoplasms.
We conducted a population-based cohort study using Washington State-linked vital-hospital discharge records. Women with neoplasms (707 malignant; 13,156 benign) with deliveries in 1987–2012 were identified, and a randomly selected comparison cohort. Obstetrical/infant outcomes and rehospitalization < 2 years post-delivery were compared separately for each group by multivariable regressions to estimate risk ratios (RR) and 95% confidence intervals (CI).
Women with either condition had increased anemia, cesarean, and preterm delivery; their infants were more often < 2,500 g or jaundiced. Women with benign conditions had increased gestational diabetes (RR = 1.20; 95% CI 1.12–1.28) and preeclampsia (RR = 1.27; 95% CI 1.18–1.36); their infants had increased malformations (RR = 1.29; 95% CI 1.19–1.38). Women with neoplasms more often were hospitalized seven or more days or rehospitalized; their infants’ hospitalizations were also longer.
Malignant and benign neoplasms were associated with several adverse outcomes. Reasons for relationships of benign neoplasms with gestational diabetes, preeclampsia, and congenital malformations merit further study.
KeywordsCancer Pregnancy-related cancer Pregnancy outcomes Infant outcomes
We would like to acknowledge the Washington State Department of Health for data access and Mr. Bill O’Brien for programming and file management.
Compliance with ethical standard
Conflicts of interest
The authors declare that they have no conflicts of interest.
- 1.Mathews TJ, Hamilton BE (2016) Mean age of mothers is on the rise: United States, 2000-2014. In: NCHS data brief, 2016. pp 1–8Google Scholar
- 2.American Cancer Society Cancer Facts & Figures 2012. In: American Cancer Society, 2012. p 68Google Scholar
- 5.Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, Melisko ME, Cedars MI, Rosen MP (2012) Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer 118:1710–1717. https://doi.org/10.1002/cncr.26459 CrossRefGoogle Scholar
- 9.Loibl S, Han SN, von Minckwitz G, Bontenbal M, Ring A, Giermek J, Fehm T, Van Calsteren K, Linn SC, Schlehe B, Gziri MM, Westenend PJ, Müller V, Heyns L, Rack B, Van Calster B, Harbeck N, Lenhard M, Halaska MJ, Kaufmann M, Nekljudova V, Amant F (2012) Treatment of breast cancer during pregnancy: an observational study. Lancet Oncol 13:887–896. https://doi.org/10.1016/S1470-2045(12)70261-9 CrossRefGoogle Scholar
- 14.Segars JH, Parrott EC, Nagel JD, Guo XC, Gao X, Birnbaum LS, Pinn VW, Dixon D (2014) Proceedings from the Third National Institutes of Health International Congress on advances in uterine leiomyoma research: comprehensive review, conference summary and future recommendations. Hum Reprod Update 20(3):309–333CrossRefGoogle Scholar
- 16.Lydon-Rochelle MT, Holt VL, Cardenas V, Nelson JC, Easterling TR, Gardella C, Callaghan WM (2005) The reporting of pre-existing maternal medical conditions and complications of pregnancy on birth certificates and in hospital discharge data. Am J Obstet Gynecol 193(1):125–134. https://doi.org/10.1016/j.ajog.2005.02.096 CrossRefGoogle Scholar
- 19.Oh SS, Galanter J, Thakur N, Pino-Yanes M, Barcelo NE, White MJ, de Bruin DM, Greenblatt RM, Bibbins-Domingo K, Wu AH, Borrell LN, Gunter C, Powe NR, Burchard EG (2015) Diversity in clinical and biomedical research: a promise yet to be fulfilled. PLoS Med 12(12):e1001918. https://doi.org/10.1371/journal.pmed.1001918 CrossRefGoogle Scholar
- 27.Roberts WE, Fulp KS, Morrison MJC, Martin JN (1999) The impact of leiomyomas on pregnancy. Aust N Z J Obstet Gynaecol 39(1):43–47. https://doi.org/10.1111/j.1479-828X.1999.tb03442.x CrossRefGoogle Scholar
- 38.Amant F, Vandenbroucke T, Verheecke M, Fumagalli M, Halaska MJ, Boere I, Han S, Gziri MM, Peccatori F, Rob L, Lok C, Witteveen P, Voigt JU, Naulaers G, Vallaeys L, Van den Heuvel F, Lagae L, Mertens L, Claes L, Van Calsteren K, International Network on Cancer I, Pregnancy (2015) Pediatric outcome after maternal cancer diagnosed during pregnancy. N Engl J Med 373(19):1824–1834. https://doi.org/10.1056/nejmoa1508913 CrossRefGoogle Scholar
- 40.McGeechan K, Kricker A, Armstrong B, Stubbs J (1998) Evaluation of linked cancer registry and hospital records of breast cancer. Aust N Z J Pub Health 22(7):765–770. https://doi.org/10.1111/j.1467-842X.1998.tb01490.x CrossRefGoogle Scholar
- 42.Baldi I, Vicari P, Di Cuonzo D, Zanetti R, Pagano E, Rosato R, Sacerdote C, Segnan N, Merletti F, Ciccone G (2008) A high positive predictive value algorithm using hospital administrative data identified incident cancer cases. J Clin Epidemiol 61(4):373–379. https://doi.org/10.1016/j.jclinepi.2007.05.017 CrossRefGoogle Scholar
- 47.Martin JA, Wilson EC, Osterman MJ, Saadi EW, Sutton SR, Hamilton BE (2013) Assessing the quality of medical and health data from the 2003 birth certificate revision: results from two states. Natl Vital Stat Rep 62(2):1–19Google Scholar
- 49.Andrade SE, Scott PE, Davis RL, Li D-K, Getahun D, Cheetham TC, Raebel MA, Toh S, Dublin S, Pawloski PA, Hammad TA, Beaton SJ, Smith DH, Dashevsky I, Haffenreffer K, Cooper WO (2013) Validity of health plan and birth certificate data for pregnancy research. Pharmacoepidemiol Drug Saf 22(1):7–15. https://doi.org/10.1002/pds.3319 CrossRefGoogle Scholar