Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study.
Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study.
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DOI：
10.1093/jnci/djx056
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发表时间：
2017-11-01
期刊：
影响因子：
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通讯作者：
Hawkins MM
中科院分区：
文献类型：
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作者：
Reulen RC;Bright CJ;Winter DL;Fidler MM;Wong K;Guha J;Kelly JS;Frobisher C;Edgar AB;Skinner R;Wallace WHB;Hawkins MM
背景：通过腹部放射疗法治疗的儿童癌症的女性幸存者有可能提供过早和低次量的后代，但是对于腹部放射疗法是否可能与怀孕期间的其他并发症有关在英国儿童癌症幸存者研究（BCCSS）中，儿童癌症女性生存中妊娠和劳动并发症的风险。
方法：通过将BCCS队列（n = 17 980）与英格兰的医院发作统计（HES）联系起来，以识别怀孕和劳动并发症。腹部/颅骨/其他）和其他癌症相关因素使用对数二项式回归。
结果：在1712年的儿童癌症中，总共有2783个单身妊娠在HES中发现了Wilms肿瘤存活。至4.71），而所有接受腹部放射疗法治疗的幸存者都有妊娠糖尿病的风险（RR = 3.35，95％CI = 1.41至7.93）和贫血使妊娠复杂化（RR = 2.10，95％CI = 1.27至3.46）没有放射疗法的幸存者接受治疗的幸存者。没有放射疗法的妊娠和劳动并发症的风险与普通人群相似，除了幸存者更有可能选择剖宫产（RR = 1.39，95％CI = 1.16至1.70）。
结论：腹部放射疗法的治疗增加了威尔姆斯肿瘤存活中妊娠并发性妊娠的风险，糖尿病和贫血使所有患者的怀孕都复杂化。
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.