Children born to women treated for cancer in the second and third trimesters of pregnancy seem to develop normally up to age 3, according to a study in the New England Journal of Medicine (NEJM). That normal development may continue, but the study’s follow-up period did not extend beyond toddlerhood.
No matter, because the study fills an anxiety-producing gap in knowledge for pregnant women with cancer, fearful that chemotherapy, radiation, or both would harm their babies. Many believed that their options were limited to inducing preterm labor or terminating the pregnancy.
“Prenatal exposure to maternal cancer with or without treatment did not impair the cognitive, cardiac, or general development of children in early childhood,” concluded researchers, led by a group at University Hospitals Leuven in Belgium.
They assessed the cognitive and cardiac development of 129 children whose mothers had cancer, with a control group of the same number. The children lived in Belgium, the Netherlands, Italy, and the Czech Republic.
During pregnancy, 96 children (74.4%) born to mothers who had cancer were exposed to chemotherapy (either alone or in combination with other treatments), 11 (8.5%) to radiotherapy (either alone or in combination with other treatments), 13 (10.1%) to surgery alone, 2 (1.6%) to other drug treatments, and 14 (10.9%) to no treatment.
Of the children born to women with cancer, 61.2% were born prematurely compared with less than 9% of the infants in the countries that participated in the study.
“Pregnant women may be informed that the likelihood of prematurity is higher than that in the general population, but among preterm babies, the child is unlikely to have unique problems more serious than those of preterm babies born of women without cancer during pregnancy,” concluded authors of the study, which was published in the Sept. 28, 2015, issue of NEJM.
Most of the mothers giving birth preterm were induced into labor so that cancer treatment could continue.
“Prematurity was correlated with a worse cognitive outcome, but this effect was independent of cancer treatment,” states the study.
Researchers were somewhat surprised by the findings since chemotherapy can cross the placenta.
“The reassuring outcome may be explained by the timing of chemotherapy administration and the role of the placenta,” the study states. “All cycles of chemotherapy in this series were administered after the first trimester of pregnancy. The period before a gestational age of 10 weeks is the most vulnerable, since organogenesis is occurring during this period.”