Introduction/Background The maternal diagnosis of cancer complicates approximately 0,1% of all pregnancies. The most frequently diagnosed malignancies are breast cancer, cervical cancer, lymphoma, ovarian cancer and melanoma. Although chemotherapy can be administered during pregnancy, its effects on obstetric and neonatal outcomes are still largely unknown. The aim of this study is to assess the oncologic management as well as the obstetric and perinatal outcomes in a consecutive series of patients diagnosed with cancer during pregnancy.
Methodology Retrospective cohort study including 47 pregnant women diagnosed with primary invasive cancer during pregnancy between 2010 and 2019 at IRCCS Policlinico di Milano and Istituto Europeo Di Oncologia (Milan, Italy). All the included patients have been treated with chemotherapy during pregnancy. Oncologic, obstetric and neonatal data have been collected and compared. Linear regression analysis was used to assess the correlation between the therapy and perinatal outcomes. All the analysis were performed with Stat Direct 2.7.9 (StatsDirect Ltd, Altrincham).
Results The most common malignancies diagnosed in our cohort of 47 women were: breast cancer as the most common type (87,2%), followed by lymphomas (6,4%). All the maternal characteristics are listed in table 1.
All the patients were treated with chemotherapy during pregnancy consisting of different number of cycles according to the gestational age at diagnosis (1 – 12). Maternal chemotherapy-related toxicity was generally lower than expected, maximum grade 1 according to National Cancer Institute – Common toxicity Criteria (NCI-CTC).
All pregnancies ended with a livebirth fetus, at a mean gestational age of 36,7 weeks. The delivery was planned at least 3 weeks after the last administration of chemotherapy: 21 patients had a vaginal delivery, 23 an elective caesarean section and 2 an emergency caesarean section.
Table 2 shows the results of the correlation between maternal chemotherapy and perinatal outcomes: neonatal birthweight percentile, Apgar score and blood count parameters. No correlation has been demonstrated neither for the number of cycles or the gestational age at diagnosis and any of the outcome considered.
Conclusion Our results show that administration of chemotherapy during pregnancy is not associated with perinatal complications. Neonatal birth weight, Apgar score and neonatal hematologic indices are not affected by the number of chemotherapy cycles and the gestational age at the beginning of the treatment.
Disclosures Nothing to disclose.
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