(ChemotherapyAdvisor) – A study of children of women exposed to chemotherapy for the treatment of cancer in pregnancy were found to develop as well as children in the general population, a study published in The Lancet Oncology online February 10 concluded.
Frédéric Amant, of the Leuven Cancer Institute, Katholieke Universiteit Leuven, Belgium, and colleagues assessed 70 children from 68 pregnancies during which 236 cycles of chemotherapy were administered. Median gestational age at cancer diagnosis was 18 weeks and median gestational age at birth, 35.7 weeks; 47 women gave birth at <37 weeks. Children were assessed at birth and from age 18 months to 18 years.
All children underwent clinical neurological examinations, cognitive functioning tests, electrocardiography and echocardiography, and completed a questionnaire on general health and development. Those aged five years and older also had audiometry and tests of verbal learning, memory, attention, and behavior.
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Compared with the general population, prenatal exposure to chemotherapy was not associated with increased CNS, cardiac, or auditory morbidity, or with general health and growth impairments.
“Our findings do not support a strategy of delay in chemotherapy administration or iatrogenic preterm delivery with postpartum chemotherapy administration to avoid harm to the fetus,” the investigators wrote, adding, “The decision to administer chemotherapy should follow the same guidelines as in nonpregnant patients. In practice, it is possible to administer chemotherapy from 14 weeks gestational age onwards with specific attention to prenatal care.”
An accompanying comment noted, “The study by Amant and colleagues has the potential to affect clinical practice: If we can present this reassuring data to pregnant women with cancer, women might be more likely to accept treatment during pregnancy when indicated. This report might encourage oncologists and obstetricians to recognize the advantages of collaboration when the subject under study such as cancer in pregnancy is rare.”
