ArticleLancet (London, England)2010
Stillbirth and neonatal death in relation to radiation exposure before conception: a retrospective cohort study.
Article in Lancet (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 162 citations in OpenAlex.
- Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study.Journal of assisted reproduction and genetics · 2015Pooled it
- The prevalence and nature of the use of preconception services by women with chronic health conditions: an integrative review.BMC women's health · 2015Pooled it
- Pregnancy outcomes in women conceiving after hematopoietic stem cell transplantation versus conventional chemotherapy for childhood or adolescent acute leukemia.Bone marrow transplantation · 2026Article
- Racial and Ethnic Disparities in Adverse Pregnancy Outcomes Among Women with Early Onset Cancer in the United States.Cancers · 2026Article
- Assessing the Risks of Prenatal Radiation: Effects on Pregnancy and Neonatal Development.Journal of pharmacy & bioallied sciences · 2025Article
- Spontaneous conception and pregnancy outcomes after multi-agent chemotherapy and high-dose radiotherapy for pelvic Ewing sarcoma: Case report and literature review.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Review
- Ovarian Insufficiency and Fertility Preservation During and After Childhood Cancer Treatment.Journal of adolescent and young adult oncology · 2024Review
- Long-term follow-up to assess criteria for ovarian tissue cryopreservation for fertility preservation in young women and girls with cancer.Human reproduction (Oxford, England) · 2023Article
- Article
- "We are in this together" - Polish midwives' reflections on perinatal care for Ukrainian women after the outbreak of war.Health psychology report · 2023Article
- Article
- Outcomes of Three Different Minimal Invasive Approaches for Secundum Atrial Septal Defect Closure: A Single Institute Experience.Current medical science · 2021Article
- Congenital Malformations and Perinatal Deaths Among the Children of Atomic Bomb Survivors: A Reappraisal.American journal of epidemiology · 2021Article
- Environment, Lifestyle, and Female Infertility.Reproductive sciences (Thousand Oaks, Calif.) · 2021Review
- Review
- The Likelihood of Adverse Pregnancy Outcomes and Genetic Disease (Transgenerational Effects) from Exposure to Radioactive Fallout from the 1945 Trinity Atomic Bomb Test.Health physics · 2020Article
- Ovarian Stimulation Is Safe and Effective for Patients with Gynecologic Cancer.Journal of adolescent and young adult oncology · 2020Article
- Risk of Being Born Preterm in Offspring of Cancer Survivors: A National Cohort Study.Frontiers in oncology · 2020Article
- ESHRE guideline: female fertility preservation.Human reproduction open · 2020Article
- Uterine irradiation as a determinant of infertility and pregnancy losses in young cancer survivors.Ecancermedicalscience · 2020Review
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe reproductive implications of mutagenic treatments given to children with cancer are not clear. By studying the risk of untoward pregnancy outcomes, we indirectly assessed the risk of transmission of germline damage to the offspring of survivors of childhood cancer who were given radiotherapy and chemotherapy.
methodsWe did a retrospective cohort analysis, within the Childhood Cancer Survivor Study (CCSS), of the risk of stillbirth and neonatal death among the offspring of men and women who had survived childhood cancer. Patients in CCSS were younger than 21 years at initial diagnosis of an eligible cancer, were treated at 25 US institutions and one Canadian institution, and had survived for at least 5 years after diagnosis. We quantified the chemotherapy given to patients, and the preconception radiation doses to the testes, ovaries, uterus, and pituitary gland, and related these to the risk of stillbirth or neonatal death using Poisson regression analysis.
findingsAmong 1148 men and 1657 women who had survived childhood cancer, there were 4946 pregnancies. Irradiation of the testes (16 [1%] of 1270; adjusted relative risk 0.8 [95% CI 0.4-1.6]; mean dose 0.53 Gy [SD 1.40]) and pituitary gland (17 [3%] of 510, 1.1 [0.5-2.4] for more than 20.00 Gy; mean dose 10.20 Gy [13.0] for women), and chemotherapy with alkylating drugs (26 [2%] of 1195 women, 0.9 [0.5-1.5]; ten [1%] of 732 men, 1.2 [0.5-2.5]) were not associated with an increased risk of stillbirth or neonatal death. Uterine and ovarian irradiation significantly increased risk of stillbirth and neonatal death at doses greater than 10.00 Gy (five [18%] of 28, 9.1 [3.4-24.6]). For girls treated before menarche, irradiation of the uterus and ovaries at doses as low as 1.00-2.49 Gy significantly increased the risk of stillbirth or neonatal death (three [4%] of 69, 4.7 [1.2-19.0]).
interpretationOur findings do not support concern about heritable genetic changes affecting the risk of stillbirth and neonatal death in the offspring of men exposed to gonadal irradiation. However, uterine and ovarian irradiation had serious adverse effects on the offspring that were probably related to uterine damage. Careful management is warranted of pregnancies in women given high doses of pelvic irradiation before puberty.
fundingWestlakes Research Institute, National Cancer Institute, and Children's Cancer Research Fund.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.