Table 3

Reported obstetrical outcome and complications of cancer during pregnancy in the largest multicenter cohort study and population based cohort studies on ‘pregnancy-associated cancer’

Reported obstetrical outcome and complications of cancer during pregnancy in the largest multicenter cohort study and population-based cohort studies on ‘pregnacy-associated cancer
ReferenceInclusion criteriaNo of patientsYears of inclusionCountriesType of cancerPregnancy outcome
OR (95% CI)		Birth weightPre-eclampsia/HELLP
PPROM and preterm contractions,
systemic infection, other		Neonatal outcome
Parazzini et al10 2017*Cancer diagnosis within 9/3 months before delivery/termination of pregnancy or within 12 months after delivery14752001–2012Lombardy, ItalyAll types1025 Live birth (69.5%)
450 Miscarriage or termination of pregnancy (30.5%)
Increased risk for miscarriage or termination of pregnancy aOR=1.22 (1.09 to 1.37)		Not reportedNot reportedNot reported
de Haan et al4 2018†Cancer diagnosis (including borderline ovarian cancer) during pregnancy1170, 1089 singleton pregnancies with known obstetric outcome1996–2016INCIP‡All types14 stillbirth (1%)
955 live birth (88%)
95 termination (9%)
20 miscarriage (2%)
430 preterm birth (39%)
458 term birth (>37 w) (42%)		167/796 (21%) SGA98 (10%) PPROM or preterm contractions
5 (<1%) maternal death during pregnancy		4% Congenital malformations
Lu et al40 2017*Cancer diagnosis during pregnancy or within 12 months after delivery, all singleton births9481973–2012SwedenAll typesIncreased risk

  • SGA-related stillbirth (RR=4.9 (2.2 to 11.0))

  • Preterm birth (RR 5.8 (5.3 to 6.5)), mainly iatrogenic

  • CS (40% vs 12%)

Increased risk preterm SGA (RR=3.0 (2.1–4.4)), mainly hematological and ovarian cancers
No increased risk term SGA (RR=1.0 (0.7–1.3))		Not reportedIncreased neonatal mortality (between 0 and 27 days) (RR=2.7 (1.3–5.6)), 89% prematurity related
El-Messidi et al,37 2015*Diagnosis of active HL or HL in immediate remission during pregnancy6382003–2001CanadaHodgkin's lymphomaIncreased risk preterm birth (aOR=1.93 (1.53 to 2.42))
No increased incidence stillbirth (1/638, 0.16%)		No increased incidence IUGR (15/638, 2.4%)Increased risk

  • VTE (aOR=7.93 (2.97–21.22))

  • blood transfusion (aOR=1.38 (1.05–1.82))

No increased incidence congenital malformations (5/638, 0.78%)
Bannister-Tyrrell et al11 2015*Diagnosis of melanoma during pregnancy or within 12 months after delivery, all birth beyond 20 weeks of gestation or 400 g birth weight577 (195 during pregnancy, 382 postnatal diagnosis)1994–2008AustraliaMelanomaNo increased risk of

  • still birth (0/195)

  • planned birth (aOR=0.87 (0.61 to 1.23)

  • CS (aOR=0.98 (0.70 to 1.38))

  • prematurity (aOR=0.82 (0.44 to 1.56))

No increased risk SGA (aOR=0.74 (0.41–1.34))
Increased risk of LGA (aOR=1.75 (1.22–2.53))		Increased risk hypertension in pregnancy (aOR=1.21 (0.93–1.58))Not reported
Lee et al9 2012*Cancer diagnosis during pregnancy or within 12 months after delivery, all births beyond 20 weeks of gestation or 400 g birth weight4991994–2008AustraliaAll typesIncreased risk of

  • IOL (aOR=1.27(1.03 to 1.56))

  • CS (aOR=2.08 (1.70 to 2.54))

  • iatrogenic prematurity (aOR=11.53 (8.81 to 15.11)), but no increased risk of spontaneous prematurity

Increased risk of VTE (aOR=10.20 (3.81–27.33))

  • sepsis (aOR=4.28 (2.57–7.13))

  • severe maternal morbidity (aOR=6.89 (4.66–10.19))


No increased risk of obstetrical hemorrhage (aOR=1.10 (0.74–1.63))		No increased risk SGA (aOR=1.20 (0.89–1.61))
Increased risk LGA (aOR=1.47 (1.14 81–1.89))		No increased risk of perinatal death
El-Messidi et al12 2015*Diagnosis of active NHL or NHL in immediate remission during pregnancy4272003–2011CanadaNon-Hodgkin's lymphomaIncreased risk of

  • CS (aOR=1.37 (1.13 to 1.67))

  • prematurity (aOR=2.50, (1.94 to 3.22))

  • stillbirth (aOR=2.71, (1.12 to 6.55))


No increased risk of IOL		No increased risk (no IUGR in 427 cases)Increased risk

  • Postpartum blood transfusion (aOR=2.73 (2.10–3.55))

  • Pre-eclampsia (aOR=1.57 (1.06–2.32))

  • Postpartum infections (aOR= 2.81 (1.16–6.79))

  • Maternal death during pregnancy (aOR=68.72 (21.94–215.27))


No increased risk VTE (aOR=2.70 (0.38–19.24))		No increased risk of congenital malformations (3/427, 0.70%)
Nazer et al13 2015*Diagnosis of malignant adnexal mass during pregnancy, all births1792003–2011CanadaOvarian cancerIncreased risk of

  • CS (aOR=5.92 (4.17 to 8.41))

  • prematurity (aOR=2.24 (1.48 to 3.42))


No increased risk of PPROM or stillbirth		No increased risk: IUGR (aOR=0.20 (0.03–1.42))Increased risk

  • Hysterectomy (aOR=60.90 (27.38–135.53)

  • VTE (aOR=5.52 (1.96–15.53))


No increased risk

  • Eclampsia (aOR=3.10 (0.43–22.31))

  • Placental abruption (aOR=1.15 (0.46–2.86))

  • Maternal death (aOR=6.78 (0.84–54.45))

Not reported
O’Meara et al42 2005*Diagnosis of melanoma during or within 1 year after pregnancy, pregnancies beyond 20 weeks of gestation145 during pregnancy
four at delivery
263 postpartum diagnoses		1991–1999USAMelanomaNo increased risk:

  • stillbirth (no reports)

  • Prematurity (aOR=0.9 (0.5 to 1.6))

  • CS (aOR=1.3 (0.9 to 1.9))

No increased risk low birth weight (aOR=0.8 (0.3–1.8))No increased risk compared with healthy controlsNo increased risks NICU admission. No neonatal deaths reported
Dalrymple et al41 2005*Diagnosis of cervical cancer during pregnancy or within 1 year after delivery, all singleton or multiple births beyond 20 weeks of gestation1361991–1999USACervical cancerIncreased risk of

  • CS (aOR=3.7 (2.6 to 5.2))

  • prematurity (aOR=4.7 (3.2 to 6.7)), both spontaneous and iatrogenic

  • stillbirth (aOR=5.5 (2.0 to 14.8))

Increased risk of SGA (aOR=5.5 (3.7–8.1))
Increased risk for extreme SGA (aOR=6.9 (3.7–12.8))		Increased risk of maternal hospitalization (aOR=14.1; (9.2, 21.5))Increased risk of neonatal admission (aOR=5.2 (3.6–7.5))
Yasmeen et al15 2005*Diagnosis of thyroid cancer during pregnancy or within 12 months after delivery, all births beyond 20 weeks of gestation1291991–1999USAThyroid cancerNo increased risk of

  • CS (aOR=1.3 (0.9 to 1.9)).

  • preterm delivery (aOR=1.5 (0.8 to 2.9))

  • stillbirth (aOR=0.6 (0.2 to 11.7))

No increased risk low birth weight (aOR=1.4 (0.7–2.7))No increased risk (hypertension, antepartum hemorrhage)No increased risk of neonatal or fetal death

  • *Population-based cohort study (by linkage of nationwide registries)

  • †International multicenter retrospective and prospective cohort study

  • ‡For countries in INCIP: see www.cancerinpregnancy.org

  • CS, cesarean section; HELLP, complication of pregnancy characterized by hemolysis, elevated liver enzymes and a low platelet count; INCIP, International Network on Cancer,Infertility and Pregnancy; IOL, induction of labor; IRR, incidence rate ratio; IUGR, intra-uterine growth restriction; LGA, large for gestational age; OR, odds ratio; PPROM, preterm premature rupture of membranes; RR, relative risk; SGA, small for gestational age; VTE, venous thromboembolism; aOR, adjusted odds ratio; all reported aORs are at least adjusted for age and race (±other factors, depending on the article).