Study Reveals Risks for Offspring of AYA Cancer Survivors

Overview of Findings

A recent study highlights an increased risk of preterm birth and low birth weight among children born to adolescent and young adult (AYA) cancer survivors. These findings underscore the need for pre-pregnancy counseling and heightened monitoring during pregnancy for this demographic.

Background on AYA Cancer Survivors

Every year, over 45,000 adolescents and young adults, aged 15 to 39, are diagnosed and treated for cancer. Understanding reproductive health and birth outcomes in this population is crucial for those considering conception or who are already expecting.

Study Details

Published in JAMA Oncology, the study conducted by researchers at the University of North Carolina examined adverse birth outcomes in female AYA cancer survivors. The researchers utilized the North Carolina Central Cancer Registry (CCR) to identify female cancer survivors diagnosed between January 2010 and December 2013. They then linked these records to statewide birth certificates issued from January 2010 to December 2014, resulting in 2,598 post-diagnosis live births.

Comparison with General Population

The data from AYA cancer survivors was compared with childbirths from women without a cancer history, ensuring that only those who matched in maternal age and year of delivery were included in the evaluation. The study revealed that live births among AYA cancer survivors are associated with higher rates of preterm births (defined as less than 37 weeks gestation) and lower birth weights (under 2,500 grams) when compared to the general population. Notably, the highest prevalence of these adverse outcomes occurred in mothers diagnosed with cancer during their pregnancy.

Impact of Treatment on Birth Outcomes

The research indicated that both preterm birth and low birth weight were more prevalent among births to women who underwent chemotherapy, particularly those diagnosed with breast cancer or non-Hodgkin’s lymphoma. Conversely, radiation treatment without chemotherapy did not adversely affect birth outcomes. The study also noted a statistically significant increase in cesarean deliveries among AYA cancer survivors.

Other Birth Outcomes

On a positive note, the prevalence of other adverse birth outcomes, such as being small for gestational age (SGA) and low Apgar scores, did not differ significantly between the two groups.

Study Strengths and Limitations

The study’s strengths include a large sample size and comprehensive data on individual treatment types and durations. However, the researchers acknowledged some limitations, such as a lack of information on child-bearing intent and the timing of attempts at parenthood. Additionally, they could not account for women who relocated out of the state during the study period.

Conclusion and Recommendations

Overall, the study emphasizes the importance of prenatal counseling for AYA cancer survivors and suggests that increased surveillance during pregnancy is necessary to ensure better health outcomes for both mothers and their children.

References

Anderson C, Engel SM, Mersereau JE, et al. Birth Outcomes Among Adolescent and Young Adult Cancer Survivors. JAMA Oncol. 2017;3(8):1078–1084. doi:10.1001/jamaoncol.2017.0029

Written By: Debapriya Dutta, PhD