Association Between Reproductive Cancer and Fetal Outcomes: A Population-Based Study

Mogos, Mulubrhan F. PhD*†; Salihu, Hamisu M. MD, PhD*‡; Aliyu, Muktar H. MD, DrPH§; Whiteman, Valerie E. MD; Sultan, Dawood H. PhD

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0b013e31827b877b
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Abstract

Purpose: This study aimed to evaluate the impact of maternal reproductive cancer diagnosis on fetal birth outcomes.

Materials and Methods: We conducted a retrospective population-based cohort study among women with a singleton live birth and diagnosed with reproductive cancer in the state of Florida (cases). We matched cases to cancer-free controls using selected sociodemographic and pregnancy-related clinical conditions. We applied logistic regression with correction for intracluster correlation using generalized estimating equations.

Results: Overall, 3212 (0.21%) of pregnant women had a diagnosis of reproductive cancer. Affected women had a 24% and 33% elevated risk for low birth weight (LBW) and preterm birth (PTB) infants, respectively. Compared to their white counterparts, black women with reproductive cancer had a greater risk for LBW [odds ratio (OR), 1.83; 95% confidence interval (CI), 1.37–2.44], small for gestational age (SGA) [OR, 1.64; 95% CI, 1.23–2.17], and PTB (OR, 1.47; 95% CI, 1.12–192) infants. Black women with breast cancer demonstrated significantly higher risks of LBW [adjusted odds ratio (AOR), 2.37; 95% CI, 1.56–3.60], PTB (AOR, 1.71; 95% CI, 1.15–2.56), and SGA (AOR, 1.72; 95% CI, 1.12–2.64) when compared to women of their racial group with no reproductive cancer.

Conclusions: Diagnosis of reproductive cancer before or during pregnancy and within 30 days after birth is associated with adverse fetal outcomes (LBW, PTB, and SGA). These results highlight the importance of preconception and intraconception care of women with reproductive cancer diagnosis.

Author Information

*Maternal and Child Health Comparative Effectiveness Research Group, Department of Epidemiology and Biostatistics, †Department of Health Policy and Management, College of Public Health, ‡Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL; §Department of Preventive Medicine and Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN.

Address correspondence and reprint requests to Hamisu M. Salihu, MD, PhD, Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612. E-mail: hsalihu@health.usf.edu.

Supported by the National Institutes of Health through a grant on Cancer health disparities (award no. 1P20MD003375-01) and the Agency for Health Care Research and Quality through a grant on Clinically Enhanced Multi-Purpose Administrative Data set for Comparative Effectiveness Research (award no. 1R0111HS019997).

The authors declare no conflicts of interest.

Received August 25, 2012

Accepted October 29, 2012

Copyright © 2013 by IGCS and ESGO