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Association Between Reproductive Cancer and Fetal Outcomes: A Systematic Review

Mogos, Mulubrhan F. PhD*; Rahman, Shams MD*; Salihu, Hamisu M. MD, PhD*†; Salinas-Miranda, Abraham A. MD, MPH*; Sultan, Dawood H. PhD

International Journal of Gynecological Cancer: September 2013 - Volume 23 - Issue 7 - p 1171–1177
doi: 10.1097/IGC.0b013e31829e9fe2
Review Articles

Objective This study aimed to review studies that addressed the impact of previous reproductive cancer diagnosis on selected fetal birth outcomes.

Materials and Methods We searched PubMed and Web of Knowledge to identify peer-reviewed articles published from January 1992 to December 2012, investigating the association between reproductive cancer and birth outcomes. After applying exclusion criteria, 49 articles were identified for full review, and 36 articles were finally selected for this systematic review. The quality of the studies was assessed by independent reviewers.

Results We found 13 cervical cancer studies, 16 ovarian cancer studies, and 7 corpus uteri cancers that reported subsequent pregnancies (n = 688 pregnancies in 477 women). Of these, 489 pregnancies reached third trimester. Among viable pregnancies, only 416 pregnancies had information on maturity status based on gestational age and/or birth weight. For those with cervical cancer, the preterm birth (PTB) rate was 48.5%. For those with ovarian cancer, there were no cases of PTB. For those with corpus uteri cancers, the PTB was 7.7%. All studies had small sample sizes, and there was considerable heterogeneity of results. Abortions, ectopic pregnancies, and terminations were also reported.

Conclusions Reproductive cancers may be associated to subsequent adverse fetal birth outcomes; however, the quality of evidence is still insufficient to infer a relationship between reproductive cancers treated conservatively and adverse fetal birth outcomes in subsequent pregnancies.

Supplemental digital content is available in the text.

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

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

The authors declare no conflicts of interest.

This work was supported by a funding from the Agency for Health Care Research and Quality (AHRQ) through a grant on Clinically Enhanced Multi-Purpose Administrative Dataset for Comparative Effectiveness Research” (Award#: 1R0111HS019997; and 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).

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (

Received March 3, 2013

Accepted May 31, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.