TY - JOUR
T1 - Early-life cancer, infertility, and risk of adverse pregnancy outcomes
T2 - a registry linkage study in Massachusetts
AU - Farland, Leslie V.
AU - Stern, Judy E.
AU - Hwang, Sunah S.
AU - Liu, Chia ling
AU - Cabral, Howard
AU - Knowlton, Richard
AU - Gershman, Susan T.
AU - Coddington, Charles C.
AU - Missmer, Stacey A.
N1 - Funding Information:
Funding was provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant No. NIH R01HD067270).
Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2021/2
Y1 - 2021/2
N2 - Purpose: Investigate the relationship between history of cancer and adverse pregnancy outcomes according to subfertility/fertility treatment. Methods: Deliveries (2004–2013) from Massachusetts (MA) Registry of Vital Records and Statistics were linked to MA assisted reproductive technology data, hospital discharge records, and Cancer Registry. The relative risks (RR) and 95% confidence intervals of adverse outcomes (gestational diabetes (GDM), gestational hypertension (GHTN), cesarean section (CS), low birth weight (LBW), small for gestational age (SGA), preterm birth (PTB), neonatal mortality, and prolonged neonatal hospital stay) were modeled with log-link and Poisson distribution generalized estimating equations. Differences by history of subfertility/fertility treatment were investigated with likelihood ratio tests. Results: Among 662,630 deliveries, 2,983 had a history of cancer. Women with cancer history were not at greater risk of GDM, GHTN, or CS. However, infants born to women with prior cancer had higher risk of LBW (RR: 1.19 [1.07–1.32]), prolonged neonatal hospital stay (RR: 1.16 [1.01–1.34]), and PTB (RR: 1.19 [1.07–1.32]). We found clinically and statistically significant differences in the relationship between cancer history and SGA by subfertility/fertility treatment (p value, test for heterogeneity = 0.02); among deliveries with subfertility or fertility treatment, those with a history of cancer experienced a greater risk of SGA (RRsubfertile: 1.36 [1.02–1.83]). Conclusions: Women with a history of cancer had greater risk of some adverse pregnancy outcomes; this relationship varied by subfertility and fertility treatment.
AB - Purpose: Investigate the relationship between history of cancer and adverse pregnancy outcomes according to subfertility/fertility treatment. Methods: Deliveries (2004–2013) from Massachusetts (MA) Registry of Vital Records and Statistics were linked to MA assisted reproductive technology data, hospital discharge records, and Cancer Registry. The relative risks (RR) and 95% confidence intervals of adverse outcomes (gestational diabetes (GDM), gestational hypertension (GHTN), cesarean section (CS), low birth weight (LBW), small for gestational age (SGA), preterm birth (PTB), neonatal mortality, and prolonged neonatal hospital stay) were modeled with log-link and Poisson distribution generalized estimating equations. Differences by history of subfertility/fertility treatment were investigated with likelihood ratio tests. Results: Among 662,630 deliveries, 2,983 had a history of cancer. Women with cancer history were not at greater risk of GDM, GHTN, or CS. However, infants born to women with prior cancer had higher risk of LBW (RR: 1.19 [1.07–1.32]), prolonged neonatal hospital stay (RR: 1.16 [1.01–1.34]), and PTB (RR: 1.19 [1.07–1.32]). We found clinically and statistically significant differences in the relationship between cancer history and SGA by subfertility/fertility treatment (p value, test for heterogeneity = 0.02); among deliveries with subfertility or fertility treatment, those with a history of cancer experienced a greater risk of SGA (RRsubfertile: 1.36 [1.02–1.83]). Conclusions: Women with a history of cancer had greater risk of some adverse pregnancy outcomes; this relationship varied by subfertility and fertility treatment.
KW - Cancer survivors
KW - Infertility
KW - Low birthweight
KW - Neonatal mortality
KW - Pregnancy
KW - Preterm birth
KW - Small for gestational age
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U2 - 10.1007/s10552-020-01371-4
DO - 10.1007/s10552-020-01371-4
M3 - Article
C2 - 33247354
AN - SCOPUS:85096875289
VL - 32
SP - 169
EP - 180
JO - Cancer Causes and Control
JF - Cancer Causes and Control
SN - 0957-5243
IS - 2
ER -