Age at Cancer Diagnosis and Adverse Pregnancy Outcomes Público
Smith, Brittany (Spring 2020)
Abstract
Studies have reported that cancer survivors are at an increased risk of preterm birth and low birth weight compared to women without history of cancer, but results for small for gestational age (SGA) are not consistent. Prior studies have not evaluated whether the risk of adverse pregnancy outcomes varies by age at cancer diagnosis although fertility outcomes have been reported to change with increasing age at cancer diagnosis. This study examines the relationship between age at cancer diagnosis and preterm birth, low birth weight and SGA while accounting for age at pregnancy. Georgia and North Carolina cancer registry data were linked to state birth records. We fit log-binomial models to estimate risk ratios (RR) comparing cancer survivors to cancer-free women matched on maternal age at delivery, parity, race/ethnicity, and education to women. Separate models were fit for four categories of age at cancer diagnosis: 20-24, 25-29, 30-34, and 35-45. Cancer survivors had an increased risk of preterm birth and low birth weight compared with cancer-free women, but the strength of the RRs did not vary across age at cancer diagnosis in a consistent pattern. Risk of preterm birth was increased for survivors diagnosed between ages 30 to 45 who were treated with chemotherapy compared with matched cancer-free women (RR = 1.94, CI95%: 1.23, 3.08). Most RRs for SGA were null, but when survivors treated with chemotherapy and invasive breast cancer survivors treated with chemotherapy were diagnosed between ages 30 and 45 there was an increased risk for SGA. These results suggest an opportunity for healthcare professionals to monitor cancer survivors for preterm birth and low birth weight, but age at cancer diagnosis does not appear to be an important predictor of adverse pregnancy outcomes.
Table of Contents
Chapter 1. Background
Introduction
Cancer
Cancer Survivorship Quality of Life
Pregnancy Outcomes
Preterm Birth
Low Birth Weight
Small for Gestational Age
Age at Cancer Diagnosis
Chapter 2. Age at Cancer Diagnosis and Adverse Pregnancy Outcomes
Introduction
Materials and Methods
Study Population
Age at Diagnosis
Outcomes
Covariates
Statistical Methods
Results
Preterm Birth
Low Birth Weight
Small for Gestational Age
Discussion
Tables
References
About this Master's Thesis
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