Cancer, pre-pregnancy chemotherapy do not increase risk of stillbirth in adolescent and young adult women

Adolescent and young adult women who were diagnosed with cancer and received chemotherapy prior to pregnancy had no higher risk of stillbirth, according to research led by Caitlin C. Murphy, PhD, MPH, with UTHealth Houston.

The study was recently published in the online version of the Journal of the National Cancer Institute.

There are very few studies of birth outcomes in adolescent and young adult women with cancer who become pregnant later. This study revealed that cancer and chemotherapy do not appear to increase the risk of stillbirth, which is critical for women concerned about their ability to give birth to a healthy child after cancer.”


Caitlin C. Murphy, associate professor of health promotion and behavioral sciences at the UTHealth School of Public Health, Houston

For one of the paper’s co-authors, Andrea C. Betts, PhD, MPH, the findings were personal.

“When I was pregnant with my first child, there was very little information about how my previous cancer treatment could affect my child,” said Betts, a researcher on the school’s campus in Dallas. “All my midwife could tell me was, ‘It’s plausible that there are increased risks.’ It is so rewarding to close this evidence gap and bring good news to the many young women who want to have children after cancer.”

Some chemotherapy and radiation treatments have gonadotoxic effects, meaning they can damage eggs. Previous studies have suggested that the health of the offspring may be affected. To test that theory, the study linked population-based data from the Texas Cancer Registry with certificates of live birth and fetal death. They included 11,696 deliveries to 8,402 women ages 15 to 39 who were diagnosed with cancer from 1995 to 2015, and compared them to the percentage of stillbirths in the general population. The percentage of stillbirths in both groups was similar, less than 1%.

“It’s the best kind of zero result,” Murphy said.

Along with Betts, co-authors from the UTHealth School of Public Health include Marlyn A. Allicock, PhD, MPH, of the Dallas campus; L. Aubree Shay, PhD, MSW, of the San Antonio campus; and Sharice M. Preston, PhD, of the Houston campus.

All are part of a team of researchers in the Adolescent and Young Adult (AYA) Scholarship, Training, and Research (STAR) Lab formed in 2020 at the UTHealth School of Public Health. Their expertise includes behavioral sciences, intervention development, epidemiology, program evaluation and health disparities.

Other co-authors were Barbara A. Cohn, PhD, of the Public Health Institute in Berkeley, California; Philip J. Lupo, PhD, MPH, of Baylor College of Medicine; and Sandi L. Pruitt, PhD, MPH, of UT Southwestern Medical Center.

Source:

Reference magazine:

Murphy, CC, et al. (2022) Stillbirth after cancer in adolescents and young adults: a population-based study. Journal of the National Cancer Institute. doi.org/10.1093/jnci/djac168.

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