The Outcomes Of Maternal And Pediatric After Maternal Cancer Diagnosed During Pregnancy

Objective The outcome of pregnant women with malignant tumor during pregnancy and delivery,as well as the outcome of neonatus is still unclear,and there are still obvious controversies in the world.The objective of this study was to evaluate the survival of pregnant women with malignant tumor,as well as the short-term and long-term outcome of neonatus.Methods This study conducted in the Southwest Hospital,Daping Hospital,Xinqiao Hospital,3 Affiliated Hospital of Third Military Medical University.Inclusion criteria were women pathological diagnosed with cancer during pregnancy,each control children were matched in a 1:1 ratio and must meet four criteria simultaneously:(1)Matched control group of pregnant women without malignant neoplasms who were born in the same hospital immediately after diagnosis of malignant tumor during pregnancy;(2)Mothers with the similar other pregnancy complications including gestational diabetes mellitus,intrahepaticcholestasisofpregnancy;(3)Mothers with similar infants that are gestational age and less than seven days;(4)Select the pregnant woman who is closest to the case group,if more than one pregnant woman meets the matching criteria during the same period.We collect maternal and pediatric information of two groups,and compared the the survival of pregnant women as well as the short-term and long-term outcome of neonatus in follow-up.Results A total of 80,524 pregnant women were screened.Of whom 83(0.1%)were diagnosed with cancer during pregnancy.Death occurs in42.2%(35/83)women during follow-up.During pregnancy,24 womenterminated pregnancy before 28 weeks and among this 8(33.3%)died.Ten women received chemotherapyand 49 did not receive chemotherapy.Compared with the matched controls,there were less incidences of premature rupture of membrane(5.1% vs 35.6%,P=0.000)and more caesarean rates(84.7% vs 52.5%,P=0.001)in pregnant women with cancer.Pregnant women in cancer group were older(30.6±5.3 vs 28.2±3.2 yrs,P=0.005),and with higher pregnancy order(2.7±1.7 vs 2.0±1.0,P=0.007).Compared with the pregnant women who had not received chemotherapy after pregnancy and delivery,the maternal mortality rate was significantly reduced(1: 9 vs 26: 23,P = 0.016).However,there was no difference in mortality of children(1: 9 vs 4: 45,P = 1.000)as well as The ASQ assessment.A group analysis of pregnancy with hematopoietic malignancy,pregnancy with thyroid cancer,pregnancy with cervical cancer,pregnancy with malignant ovarian cancer,pregnancy with breast cancer and pregnancy with other malignant tumors was conducted.The incidence of premature rupture of membranes was significantly lower than that of the matched controls,while the cesarean section and maternal mortality were significantly higher than those of the control group.However,there was no significant difference in Apgar score and ASQ III evaluation between the pregnant women with malignant tumor and the control group.Conclusion Chemotherapy administratered in second and third trimesters may be safe.It results in reduced mortality of women diagnosed with cancer during pregnancy,possibly without affecting the mortality of children and ASQ-associated development.Especially in cases of pregnancy with hematopoietic malignancy,pregnancy with thyroid cancer,pregnancy with cervical cancer,pregnancy with malignant ovarian cancer and pregnancy with breast cancer,chemotherapy in second and third trimesters can significantly reduce premature rupture of membranes and maternal mortality as well as no adverse effect on the survival of newborns.Given the limited number of cases,enough samples are needed for further verification.