Clinical heart failure during pregnancy and delivery in a cohort of female childhood cancer survivors treated with anthracyclines.

The cumulative incidence of peripartum anthracycline-induced clinical heart failure (A-CHF) was evaluated in a cohort of 53 childhood cancer survivors who had delivered one or more children. None of them developed peripartum A-CHF (cumulative incidence 0%; 95% confidence interval (CI) 0-5.7%). The mean follow-up time after the first administration of anthracycline therapy was 20.3 years. They received a mean cumulative anthracycline dose of 267 mg/m2. It is worth noticing that even 2 patients with A-CHF before pregnancy did not develop peripartum A-CHF. Since there were no cases of peripartum A-CHF in our cohort, it was not possible to evaluate associated risk factors. In conclusion, this study demonstrates a low risk of developing peripartum A-CHF in childhood cancer survivors. However, more cohort studies with adequate power and long-term follow-up are needed to reliably evaluate the cumulative incidence of peripartum anthracycline-induced cardiotoxicity (both clinical and asymptomatic) and associated risk factors.