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Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
T. Vandenbroucke, M. Verheecke, M. van Gerwen, K. Van Calsteren, MJ. Halaska, M. Fumagalli, R. Fruscio, A. Gandhi, M. Veening, L. Lagae, PB. Ottevanger, JU. Voigt, J. de Haan, MM. Gziri, C. Maggen, L. Mertens, G. Naulaers, L. Claes, F. Amant,...
Language English Country Great Britain
Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
- MeSH
- Diastole drug effects MeSH
- Child MeSH
- Adult MeSH
- Intelligence drug effects MeSH
- Humans MeSH
- Pregnancy Complications, Neoplastic drug therapy radiotherapy MeSH
- Memory drug effects MeSH
- Child, Preschool MeSH
- Prospective Studies MeSH
- Antineoplastic Agents adverse effects MeSH
- Pregnancy MeSH
- Child Development drug effects radiation effects MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Data on the long-term effects of prenatal exposure to maternal cancer and its treatment on child development are scarce. METHODS: In a multicenter cohort study, the neurologic and cardiac outcomes of 6-year-old children born to women diagnosed with cancer during pregnancy were compared with the outcome of children born after an uncomplicated pregnancy. Assessment included clinical evaluation, comprehensive neuropsychological testing, electrocardiography and echocardiography. RESULTS: In total, 132 study children and 132 controls were included. In the study group, 97 children (73.5%) were prenatally exposed to chemotherapy (alone or in combination with other treatments), 14 (10.6%) to radiotherapy (alone or in combination), 1 (0.8%) to trastuzumab, 12 (9.1%) to surgery alone and 16 (12.1%) to no treatment. Although within normal ranges, statistically significant differences were found in mean verbal IQ and visuospatial long-term memory, with lower scores in the study versus control group (98.1, 95% confidence interval [CI]: 94.5-101.8, versus 104.4, 95% CI: 100.4-108.4, P = 0.001, Q < 0.001 [Q refers to the false discovery rate adjusted P value], and 3.9, 95% CI: 3.6-4.3, versus 4.5, 95% CI: 4.1-4.9, P = 0.005, Q = 0.045, respectively). A significant difference in diastolic blood pressure was found, with higher values in chemotherapy-exposed (61.1, 95% CI: 59.0 to 63.2) versus control children (56.0, 95% CI 54.1 to 57.8) (P < 0.001, Q < 0.001) and in a subgroup of 59 anthracycline-exposed (61.8, 95% CI: 59.3 to 64.4) versus control children (55.9, 95% CI: 53.6 to 58.1) (P < 0.001, Q = 0.02). CONCLUSIONS: Children prenatally exposed to maternal cancer and its treatment are at risk for lower verbal IQ and visuospatial long-term memory scores and for higher diastolic blood pressure, but other cognitive functions and cardiac outcomes were normal at the age of 6 years. CLINICAL TRIAL REGISTRATION: The study is registered at ClinicalTrials.gov, NCT00330447.
Clinic of Obstetrics and Gynecology University of Milan Bicocca and San Gerardo Hospital Monza Italy
Data Scientist Knowledge Center SD Worx Antwerp Belgium
Department of Cardiology The Hospital for Sick Children University of Toronto Toronto ON Canada
Department of Cardiology University Hospitals Leuven Leuven Belgium
Department of Clinical Sciences and Community Health University of Milan Milan Italy
Department of Development and Regeneration KU Leuven Leuven Belgium
Department of Internal Medicine Radboud UMC Nijmegen the Netherlands
Department of Neonatology University Hospitals Leuven Leuven Belgium
Department of Obstetrics and Gynecology 3rd Medical Faculty Charles University Prague Czech Republic
Department of Obstetrics and Gynecology University Hospitals Leuven Leuven Belgium
Department of Obstetrics Cliniques Universitaires St Luc Brussels Belgium
Department of Oncology KU Leuven Leuven Belgium
Department of Pediatrics University Hospitals Leuven Leuven Belgium
Department of Public Health and Primary Care Faculty of Medicine KU Leuven Leuven Belgium
Faculty Hospital Kralovske Vinohrady Prague Czech Republic
Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
Neonatal Intensive Care Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
Princess Máxima Center for Pediatric Oncology Utrecht the Netherlands
References provided by Crossref.org
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- $a Vandenbroucke, Tineke $u Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
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- $a BACKGROUND: Data on the long-term effects of prenatal exposure to maternal cancer and its treatment on child development are scarce. METHODS: In a multicenter cohort study, the neurologic and cardiac outcomes of 6-year-old children born to women diagnosed with cancer during pregnancy were compared with the outcome of children born after an uncomplicated pregnancy. Assessment included clinical evaluation, comprehensive neuropsychological testing, electrocardiography and echocardiography. RESULTS: In total, 132 study children and 132 controls were included. In the study group, 97 children (73.5%) were prenatally exposed to chemotherapy (alone or in combination with other treatments), 14 (10.6%) to radiotherapy (alone or in combination), 1 (0.8%) to trastuzumab, 12 (9.1%) to surgery alone and 16 (12.1%) to no treatment. Although within normal ranges, statistically significant differences were found in mean verbal IQ and visuospatial long-term memory, with lower scores in the study versus control group (98.1, 95% confidence interval [CI]: 94.5-101.8, versus 104.4, 95% CI: 100.4-108.4, P = 0.001, Q < 0.001 [Q refers to the false discovery rate adjusted P value], and 3.9, 95% CI: 3.6-4.3, versus 4.5, 95% CI: 4.1-4.9, P = 0.005, Q = 0.045, respectively). A significant difference in diastolic blood pressure was found, with higher values in chemotherapy-exposed (61.1, 95% CI: 59.0 to 63.2) versus control children (56.0, 95% CI 54.1 to 57.8) (P < 0.001, Q < 0.001) and in a subgroup of 59 anthracycline-exposed (61.8, 95% CI: 59.3 to 64.4) versus control children (55.9, 95% CI: 53.6 to 58.1) (P < 0.001, Q = 0.02). CONCLUSIONS: Children prenatally exposed to maternal cancer and its treatment are at risk for lower verbal IQ and visuospatial long-term memory scores and for higher diastolic blood pressure, but other cognitive functions and cardiac outcomes were normal at the age of 6 years. CLINICAL TRIAL REGISTRATION: The study is registered at ClinicalTrials.gov, NCT00330447.
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