ArticleJournal of the National Cancer Institute2022
Obstetrical and Perinatal Outcomes in Female Survivors of Childhood and Adolescent Cancer: A Population-Based Cohort Study.
Article in Journal of the National Cancer Institute, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Impact of cancer treatment on fertility in female childhood and adolescent cancer survivors: a systematic review and meta-analysis.BMC cancer · 2026Pooled it
- Cancer and fertility management: FIGO best practice advice.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Pregnancy outcomes in women conceiving after hematopoietic stem cell transplantation versus conventional chemotherapy for childhood or adolescent acute leukemia.Bone marrow transplantation · 2026Article
- Fertility preservation and subsequent reproductive outcomes in female pediatric patients with hematologic malignancies.Frontiers in endocrinology · 2026Review
- Reproduction outcomes and prognostic significance of pregnancy after nasopharyngeal carcinoma treatment.Annals of medicine · 2025Article
- Risk for Unplanned Pregnancy Among Survivors of Childhood Cancer.Pediatric blood & cancer · 2025Article
- Spanish Society of Medical Oncology recommendations for comprehensive assessment and care of cancer survivors' needs.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Live birth and maternity outcome in childhood and adolescent cancer survivors under 18 years at diagnosis: a 40-year population-based cohort study.British journal of cancer · 2024Article
- Doxorubicin-induced cardiotoxicity and risk factors.International journal of cardiology. Heart & vasculature · 2024Article
- Risk of adverse birth outcomes after adolescent and young adult cancer.JNCI cancer spectrum · 2024Article
- Cancer survivorship and risk of pregnancy complications, adverse obstetric outcomes, and maternal morbidities in female adolescents and young adults: a nationwide population-based study from Taiwan.British journal of cancer · 2023Article
- Making sense of the risks: what to tell adolescents and young adults diagnosed with cancer during pregnancy.Journal of the National Cancer Institute · 2023Article
- The Burden of Surviving Childhood Medulloblastoma: A Population-Based, Matched Cohort Study in Ontario, Canada.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Stillbirth After Adolescent and Young Adult Cancer: A Population-Based Study.Journal of the National Cancer Institute · 2022Article
- Maternal Cardiovascular Outcomes of Pregnancy in Childhood, Adolescent, and Young Adult Cancer Survivors.Journal of cardiovascular development and disease · 2022Review
- Enhancing Evidence for Preconception and Prenatal Counseling on Obstetrical Risks After Cancer.Journal of the National Cancer Institute · 2022Article
- Women at heart: Introducing gender cardio-oncology.Frontiers in cardiovascular medicine · 2022Review
- Article
- Cancer treatment and survivorship statistics, 2025.CA: a cancer journal for cliniciansArticle
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7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe likelihood of pregnancy and risk of obstetrical or perinatal complications is inadequately documented in female survivors of pediatric cancer.
methodsWe assembled a population-based cohort of female survivors of cancer diagnosed at age 21 years and younger in Ontario, Canada, between 1985 and 2012. Survivors were matched 1:5 to women without prior cancer. Multivariable Cox proportional hazards and modified Poisson models assessed the likelihood of a recognized pregnancy and perinatal and maternal complications.
resultsA total of 4062 survivors were matched to 20 308 comparisons. Median (interquartile range) age was 11 (4-15) years at cancer diagnosis and 25 (19-31) years at follow-up. By age 30 years, the cumulative incidence of achieving a recognized pregnancy was 22.3% (95% confidence interval [CI] = 20.7% to 23.9%) among survivors vs 26.6% (95% CI = 25.6% to 27.3%) among comparisons (hazard ratio = 0.80, 95% CI = 0.75 to 0.86). A lower likelihood of pregnancy was associated with a brain tumor, alkylator chemotherapy, cranial radiation, and hematopoietic stem cell transplantation. Pregnant survivors were as likely as cancer-free women to carry a pregnancy >20 weeks (relative risk [RR] = 1.01, 95% CI = 0.98 to 1.04). Survivors had a higher relative risk of severe maternal morbidity (RR = 2.31, 95% CI = 1.59 to 3.37), cardiac morbidity (RR = 4.18, 95% CI = 1.89 to 9.24), and preterm birth (RR = 1.57, 95% CI = 1.29 to 1.92). Preterm birth was more likely in survivors treated with hematopoietic stem cell transplantation (allogenic: RR = 8.37, 95% CI = 4.83 to 14.48; autologous: RR = 3.72, 95% CI = 1.66 to 8.35).
conclusionsSurvivors of childhood or adolescent cancer are less likely to achieve a pregnancy and, once pregnant, are at higher risk for severe maternal morbidity and preterm birth.
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