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    Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study

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    Access Status
    Open access
    Authors
    Haggar, F.
    Pereira, Gavin
    Preen, D.
    D'Arcy Holman, C.
    Einarsdottir, K.
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Haggar, F. and Pereira, G. and Preen, D. and D'Arcy Holman, C. and Einarsdottir, K. 2014. Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study. PLoS ONE. 9 (12): e113292.
    Source Title
    PLoS ONE
    DOI
    10.1371/journal.pone.0113292
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/4.0/

    URI
    http://hdl.handle.net/20.500.11937/29764
    Collection
    • Curtin Research Publications
    Abstract

    Objective - To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods - Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982–2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. Results - Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51–2.74), gestational diabetes (2.65, 2.08–3.57), pre-eclampsia (1.32, 1.04–1.87), post-partum hemorrhage (2.83, 1.92–4.67), cesarean delivery (2.62, 2.22–3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72–5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21–2.08), low birth weight (<2500 g: 1.51, 1.23–2.12), fetal growth restriction (3.27, 2.45–4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28–3.56), need for resuscitation (1.66, 1.27–2.19) or special care nursery admission (1.44, 1.13–1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors. Conclusion - Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention.

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