ArticleActa obstetricia et gynecologica Scandinavica2026
Subsequent pregnancies after a diagnosis of pregnancy-associated cancer.
Article in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPregnancy-associated cancer is a rare but clinically significant event. Decisions regarding subsequent pregnancies after such a diagnosis are complex and influenced by medical, psychological, and social factors. This study aimed to investigate the probability of having a subsequent pregnancy following a diagnosis of a pregnancy-associated cancer. MATERIAL AND
methodsWe conducted a record-linkage cohort study using the regional health databases of Lombardy, including the hospital discharge records and the certificate of delivery assistance. Pregnancies were deliveries and abortions occurring between 1 January 2007 and 31 December 2017. Pregnancy-associated cancer was defined as any malignant neoplasm first diagnosed during pregnancy or within 1 year after the end of pregnancy, identified through hospital admissions carrying a new cancer diagnosis. To ascertain subsequent pregnancies after a diagnosis of pregnancy-associated cancer, we tracked deliveries and abortions through 31 December 2023. We estimated the incidence of pregnancy-associated cancer per 1000 pregnancies with the corresponding 95% confidence intervals (CIs) and calculated the cumulative probability of a post-diagnosis pregnancy using the cumulative incidence function that accounts for the competing risk of death.
resultsA total of 832 incident pregnancy-associated cancers were recorded among deliveries and 325 among abortions, corresponding to incidence rates of 1.12 per 1000 deliveries (95% CI, 1.04-1.19) and 1.27 per 1000 abortions (95% CI, 1.13-1.41). Breast cancer was the most frequent diagnosis in both groups (31% among deliveries, 40% among abortions), followed by thyroid cancer; the third most common site was lymphoma among deliveries and cervical cancer among abortions. During follow-up, 77 women had a subsequent pregnancy (59 deliveries, 18 abortions), yielding a cumulative probability of 7.3%. Stratified by age at diagnosis, women under 35 had a substantially higher probability of subsequent pregnancy compared to women aged 35 or older (14.0% vs. 3.5%, p < 0.01). Furthermore, the cumulative probability of subsequent pregnancy was lower among women treated with antineoplastic therapy than among those who were not treated (4.3% vs. 10.1%, p < 0.01).
conclusionsSubsequent pregnancies following a pregnancy-associated cancer diagnosis were relatively uncommon, highlighting the need for integrated reproductive counseling within a multidisciplinary approach.
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