OBJECTIVE: To characterise pregnant women diagnosed with primary or recurrent cancer who died during pregnancy, during delivery or within 1 year postpartum. DESIGN: A descriptive study. SETTING: The registry of the International Network on Cancer, Infertility and Pregnancy (INCIP). POPULATION: Women diagnosed with cancer during pregnancy between 2000 and 2022. METHODS: Using the INCIP registry database, we compared the characteristics of all women with cancer who died during pregnancy, delivery or within 1 year postpartum with those of all women with cancer who survived the first year postpartum. MAIN OUTCOME MEASURES: Maternal and tumour characteristics and obstetrical and neonatal outcomes. RESULTS: Of the 2359 women registered in INCIP, there were 131 cases (5.6%) of maternal mortality. Lung cancer (9/14, 64.3% of all registered women with lung cancer), gastro-oesophageal cancer (13/21, 61.9%) and acute leukaemia (17/105, 16.2%) had the highest rates of maternal mortality. Maternal mortality was associated with fewer live births compared with the control group without maternal mortality (99/131, 75.6%, vs 1952/2163, 90.0%; P < 0.001), more elective caesarean sections (64/104, 60.4%, vs 756/1836, 41.2%; P < 0.001) and a lower gestational age at (induced) delivery (34.0 vs 37.1 weeks; P < 0.001), resulting in more preterm births. CONCLUSIONS: Maternal mortality occurred in 5.6% of cancer-in-pregnancy cases and is associated with adverse perinatal outcomes.

Amsterdam Reproduction and Development Amsterdam the Netherlands

Clinic of Obstetrics and Gynaecology University of Milan Bicocca Fondazione IRCCS San Gerardo Monza Italy

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

Department of Gynaecological Oncology Centre of Gynaecological Oncology Amsterdam Location Antoni van Leeuwenhoek Netherlands Cancer Institute Amsterdam the Netherlands

Department of Medical Oncology Amsterdam University Medical Centre Cancer Centre Amsterdam Vrije Universiteit Amsterdam Amsterdam the Netherlands

Department of Medical Oncology Erasmus MC Cancer Institute Rotterdam the Netherlands

Department of Obstetrics and Gynaecology Amsterdam University Medical Centre Vrije Universiteit Amsterdam The Netherlands

Department of Obstetrics and Gynaecology Cooper University Health Care Camden New Jersey USA

Department of Obstetrics and Gynaecology University of Turin Città Della Salute e Della Scienza Sant'Anna Hospital Turin Italy

Department of Obstetrics Cliniques Universitaires St Luc UCL Sint Lambrechts Woluwe Belgium

Department of Oncology KU Leuven Leuven Belgium

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

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

Hospital Regional de Alta Especialidad de Ixtapaluca 'Reference Clinic for Hemato Oncological Diseases during Pregnancy CREHER' Estado de México Ixtapaluca Mexico

Princess Máxima Centre for Paediatric Oncology Utrecht the Netherlands

University Hospital Kralovske Vinohrady and 3rd Medical Faculty Charles University Prague Czech Republic

University Medical Centre Wilhelmina Children's Hospital Utrecht the Netherlands

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