Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.This multicenter cohort study reports on the long-term effects of prenatal exposure to maternal cancer and its treatment on cognitive and behavioral outcomes in 9-year-old children. In total, 151 children (mean age, 9.3 years; range, 7.8-10.6 years) were assessed using a neurocognitive test battery and parent-report behavioral questionnaires. During pregnancy, 109 children (72.2%) were exposed to chemotherapy (only or in combination with other treatment modalities), 18 (11.9%) to surgery only, 16 (10.6%) to radiotherapy, one to trastuzumab, and 16 (10.6%) were not exposed to oncologic treatment. Mean cognitive and behavioral outcomes were within normal ranges. Gestational age at birth showed a positive association with Full Scale Intelligence Quotient (FSIQ), with the average FSIQ score increasing by 1.6 points for each week increase in gestational age (95% CI, 0.7 to 2.5; P < .001). No difference in FSIQ was found between treatment types (F[4,140] = 0.45, P = .776). In children prenatally exposed to chemotherapy, no associations were found between FSIQ and chemotherapeutic agent, exposure level, or timing during pregnancy. These results indicate a reassuring follow-up during the critical maturational period of late childhood, when complex functions develop and rely on the integrity of early brain development. However, associations were observed with preterm birth, maternal death, and maternal education.

Amsterdam Reproduction and Development Child Development Amsterdam the Netherlands

Center for Gynecological Oncology Netherlands Cancer Institute Amsterdam the Netherlands

Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam UMC University of Amsterdam the Netherlands

Department of Clinical Sciences and Community Health University of Milan Milano Italy

Department of Development and Regeneration Unit Locomotor and Neurological Disorders KU Leuven Belgium

Department of Development and Regeneration Unit of Woman and Child KU Leuven Belgium

Department of Medicine and Surgery Clinic of Obstetrics and Gynecology University of Milan Bicocca San Gerardo Hospital Monza Italy

Department of Obstetric Gynecology University Hospital Kralovske Vinohrady and 3rd Medical Faculty Charles University Prague Czech Republic

Department of Obstetrics and Gynecology Cooper University Health Care Camden NJ

Department of Oncology Laboratory of Experimental Radiotherapy KU Leuven Belgium

Department of Oncology Unit of Gynaecological Oncology KU Leuven Belgium

Department of Oncology Unit of Pediatric Oncology KU Leuven Belgium

Division of Foetomaternal Medicine Department of Obstetrics and Gynaecology UZ Leuven Belgium

Division of Gynaecological Oncology Department of Obstetrics and Gynaecology UZ Leuven Belgium

Division of Pediatric Hemato Oncology Department of Pediatrics UZ Leuven Belgium

Division of Pediatric Neurology Department of Pediatrics UZ Leuven Belgium

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico NICU Milano Italy

Princess Máxima Center for Pediatric Oncology Utrecht the Netherlands

UMCU Wilhelmina Children's Hospital Utrecht the Netherlands

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