Perinatal outcomes of a pregnancy complicated by cancer, including neonatal follow-up after in utero exposure to chemotherapy: results of an international registry.

OBJECTIVE: Because of few cases at any 1 institution, pooling information on the treatment of pregnant women diagnosed with cancer and long-term follow-up of their children is important.
METHODS: Women diagnosed with cancer between their last menstrual period and end of pregnancy were voluntarily enrolled in the Cancer and Pregnancy Registry. Details of cancer treatment and pregnancy outcomes were collected. Neonatal follow-up is obtained yearly.
RESULTS: Two hundred thirty-one women were enrolled over a 13-year period. Thirteen women elected termination. One hundred fifty-seven neonates were exposed to chemotherapy in utero. Mean gestational age at delivery for neonates exposed to chemotherapy was 35.8 +/- 2.8 weeks, mean birth weight was 2647 +/- 713 g. Six children (3.8%) were born with a congenital anomaly. An intrauterine fetal demise and a neonatal death occurred in 1 case each (0.7% in each). In 12 cases (7.7%), the neonate measured <10% for gestational age at birth. Nine cases (5.8%) delivered spontaneously premature. Sixty-seven women did not receive chemotherapy during pregnancy and delivered 70 neonates. The mean gestational age at delivery was 36.5 +/- 3.3 weeks, mean birth weight was 2873 +/- 788 g. Mean neonatal follow-up is 3 years postpartum and is provided by cancer type and chemotherapy regimen.
CONCLUSIONS: In pregnancies exposed to chemotherapy after the first trimester, congenital anomalies, preterm delivery, and growth restriction were not increased as compared with general population norms. Mean gestational age at delivery was not significantly different than neonates who were not exposed to chemotherapy. There was a statistical significant difference in the birth weight between groups, which may not be clinically significant.