1. Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
- Author
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Fedro A. Peccatori, Anna Babkova, Monica Fumagalli, Amarendra Gandhi, Michael J. Halaska, Charlotte Maggen, Ingrid A. Boere, Sofia Passera, Christianne A. R. Lok, Giovanna Scarfone, Magali Verheecke, Laurence Claes, Vít Drochýtek, Mathilde van Gerwen, Vincent Rigo, Martine van Grotel, Jorine de Haan, Martina Delle Marchette, Marry M. van den Heuvel-Eibrink, Gunnar Naulaers, Robert Fruscio, Tineke Vandenbroucke, Maria Lucia Boffi, Lieven Lagae, Mina Mhallem Gziri, Fabio Mosca, Margreet A. Veening, Jens-Uwe Voigt, Jana Dekrem, Luc Mertens, Kristel Van Calsteren, Christianne J.M. de Groot, Frédéric Amant, Vera E. R. A. Wolters, Els Witteveen, Odoardo Picciolini, Camilla Fontana, Jeroen Blommaert, Petronella B. Ottevanger, Renata Nacinovich, Frédéric Goffin, Carolina P. Schröder, Obstetrics and Gynaecology, CCA - Cancer Treatment and Quality of Life, ARD - Amsterdam Reproduction and Development, Obstetrics, Vandenbroucke, T, Verheecke, M, van Gerwen, M, Van Calsteren, K, Halaska, M, Fumagalli, M, Fruscio, R, Gandhi, A, Veening, M, Lagae, L, Ottevanger, P, Voigt, J, de Haan, J, Gziri, M, Maggen, C, Mertens, L, Naulaers, G, Claes, L, Amant, F, Blommaert, J, Dekrem, J, Goffin, F, Rigo, V, Fontana, C, Mosca, F, Passera, S, Picciolini, O, Scarfone, G, Peccatori, F, Boffi, M, Delle Marchette, M, Nacinovich, R, Lok, C, Wolters, V, Boere, I, Witteveen, E, Schroder, C, de Groot, C, van Grotel, M, van den Heuvel-Eibrink, M, Babkova, A, Drochytek, V, Obstetrics and gynaecology, Pediatric surgery, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Erasmus MC other, Medical Oncology, and Pathology
- Subjects
0301 basic medicine ,Male ,Pediatrics ,Cancer Research ,Memory/drug effects ,Intelligence ,Pregnancy Complications, Neoplastic/drug therapy ,0302 clinical medicine ,Diastole ,Pregnancy ,Antineoplastic agents ,Medicine ,Childbirth ,Fertility preservation ,Prospective Studies ,Child ,Child development ,Original Research ,media_common ,Cervical cancer ,0303 health sciences ,Prenatal exposure delayed effect ,Intelligence quotient ,Obstetrics ,High risk ,Hematology ,Prenatal exposure delayed effects ,Chemotherapy regimen ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,3. Good health ,Antineoplastic agent ,Oncology ,030220 oncology & carcinogenesis ,Female ,Pregnancy Complications, Neoplastic ,Cohort study ,Adult ,medicine.medical_specialty ,Child, preschool ,media_common.quotation_subject ,Fertility ,Follow-up studies ,03 medical and health sciences ,Intelligence/drug effects ,Breast cancer ,SDG 3 - Good Health and Well-being ,Memory ,media_common.cataloged_instance ,Humans ,European union ,Child Development/drug effects ,030304 developmental biology ,Diastole/drug effects ,Follow-up studie ,business.industry ,Cancer ,Infant ,Antineoplastic Agents/adverse effects ,medicine.disease ,Clinical trial ,030104 developmental biology ,business - Abstract
Background Data on the long-term effects of prenatal exposure to maternal cancer and its treatment on child development are scarce. Methods In a multicenter cohort study, the neurologic and cardiac outcomes of 6-year-old children born to women diagnosed with cancer during pregnancy were compared with the outcome of children born after an uncomplicated pregnancy. Assessment included clinical evaluation, comprehensive neuropsychological testing, electrocardiography and echocardiography. Results In total, 132 study children and 132 controls were included. In the study group, 97 children (73.5%) were prenatally exposed to chemotherapy (alone or in combination with other treatments), 14 (10.6%) to radiotherapy (alone or in combination), 1 (0.8%) to trastuzumab, 12 (9.1%) to surgery alone and 16 (12.1%) to no treatment. Although within normal ranges, statistically significant differences were found in mean verbal IQ and visuospatial long-term memory, with lower scores in the study versus control group (98.1, 95% confidence interval [CI]: 94.5–101.8, versus 104.4, 95% CI: 100.4–108.4, P = 0.001, Q, Highlights • Cancer treatment including chemotherapy is possible during pregnancy. • Children are at risk for lower verbal IQ and visuospatial long-term memory scores. • Other cognitive functions and cardiac outcomes were normal at the age of 6 years. • We documented ototoxicity in three children exposed to cisplatin. • Follow-up until adulthood is recommended.
- Published
- 2020
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