Outcomes after cancer in pregnancy

A new diagnosis of cancer during pregnancy is devastating, and concerns about the effects of treatment on the fetus are such that many women choose to delay it until after delivery. A case-control study from Belgium should be reassuring (Amant F, et al. NEJM 2015. doi: 10.1056/NEJMoa1508913). Researchers recruited 129 children whose mothers had cancer during pregnancy: 10% had received surgery alone, 32% chemotherapy alone, and 37% both. 8% had received radiotherapy in some combination. 11% had received no treatment. A similar number of control infants were recruited from healthy mothers.

Congenital malformation rates were comparable to the general population and did not differ between the groups. Neurodevelopment was assessed at 18 and 36 months using Bayley scales, and no differences were found. Echocardiograms at 36 months were all normal. This is particularly reassuring as 26 of the mothers had received cardiotoxic anthracyclines. The only difference noted was a slightly higher incidence of small-for-gestational-age amongst the cases (22% vs 15% <10th centile) but this was not statistically significant. This is very reassuring, …