Allison A Gockley1, Alexander Melamed1, Naima T Joseph1, Mark Clapp1, Sue Yazaki Sun2, Donald P Goldstein3, Neil S Horowitz3, Ross S Berkowitz4. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA; Vincent Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Boston, USA; Department of Obstetrics, Gynecology & Reproductive Biology, Harvard Medical School Boston, MA, USA. 2. Department of Obstetrics, Paulista School of Medicine, UNIFESP - São Paulo Federal University, São Paulo, SP, Brazil; Trophoblastic Disease Center of São Paulo Hospital, Paulista School of Medicine, UNIFESP - São Paulo Federal University, São Paulo, SP, Brazil; New England Trophoblastic Disease Center, Donald P. Goldstein M.D., Trophoblastic Tumor Registry, Boston, USA. 3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA; Gynecologic Oncology Program, Susan F. Smith Center for Women's Cancers, Dana Farber Cancer Institute/Harvard Cancer Center, Boston, USA; New England Trophoblastic Disease Center, Donald P. Goldstein M.D., Trophoblastic Tumor Registry, Boston, USA. 4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA; Gynecologic Oncology Program, Susan F. Smith Center for Women's Cancers, Dana Farber Cancer Institute/Harvard Cancer Center, Boston, USA; New England Trophoblastic Disease Center, Donald P. Goldstein M.D., Trophoblastic Tumor Registry, Boston, USA. Electronic address: rberkowitz@partners.org.
Abstract
OBJECTIVE: To compare the age-specific incidence of complete (CM) and partial molar (PM) pregnancy in a large tertiary care center in the United States. METHODS: Incidence rates of CM and PM per 10,000 live births were calculated using databases from Brigham and Women's Hospital, between 2000 and 2013. Age-specific rates were calculated for women younger than 20 years old (adolescents), 20-39 years old (average age), and 40 years and older (advanced maternal age). Pearson χ(2) test was used to evaluate potential differences among groups. Rate ratios (RR) and 95% confidence intervals (CI) were used to compare risk of molar pregnancy among average age women with that of adolescents and women of advanced age. Holm-Bonferonni adjustment was used to correct for multiple comparisons. RESULTS: Between 2000 and 2013, there were 255 molar pregnancies (140 CM and 115 PM) and 105,942 live births, corresponding to a molar pregnancy rate of 24 per 10,000 live births (95% CI 21-27). Rates of CM and PM were 13 (95% CI 11-16) and 11 (95% CI 9-14) per 10,000 live births respectively. The incidence of CM differed significantly among maternal age groups (p<0.001). Compared to average age women, adolescents were 7.0 times as likely to develop CM (95% CI 3.6-8.9, p<0.001), and women with advanced maternal age were nearly twice as likely (1.9, 95% CI 1.8-4.7, p=0.002). The rate of PM did not vary significantly among age groups (p=0.26). CONCLUSIONS: Adolescence and advanced maternal age were associated with increased risk of complete mole, but not partial mole.
OBJECTIVE: To compare the age-specific incidence of complete (CM) and partial molar (PM) pregnancy in a large tertiary care center in the United States. METHODS: Incidence rates of CM and PM per 10,000 live births were calculated using databases from Brigham and Women's Hospital, between 2000 and 2013. Age-specific rates were calculated for women younger than 20 years old (adolescents), 20-39 years old (average age), and 40 years and older (advanced maternal age). Pearson χ(2) test was used to evaluate potential differences among groups. Rate ratios (RR) and 95% confidence intervals (CI) were used to compare risk of molar pregnancy among average age women with that of adolescents and women of advanced age. Holm-Bonferonni adjustment was used to correct for multiple comparisons. RESULTS: Between 2000 and 2013, there were 255 molar pregnancies (140 CM and 115 PM) and 105,942 live births, corresponding to a molar pregnancy rate of 24 per 10,000 live births (95% CI 21-27). Rates of CM and PM were 13 (95% CI 11-16) and 11 (95% CI 9-14) per 10,000 live births respectively. The incidence of CM differed significantly among maternal age groups (p<0.001). Compared to average age women, adolescents were 7.0 times as likely to develop CM (95% CI 3.6-8.9, p<0.001), and women with advanced maternal age were nearly twice as likely (1.9, 95% CI 1.8-4.7, p=0.002). The rate of PM did not vary significantly among age groups (p=0.26). CONCLUSIONS: Adolescence and advanced maternal age were associated with increased risk of complete mole, but not partial mole.