Effects of Fetal Exposure to Maternal Chemotherapy

Authors: Jana Dekrem Kristel Van Calsteren Frédéric Amant

Publish Date: 2013/07/16

Volume: 15, Issue: 5, Pages: 329-334

PDF Link

Abstract

Approximately 1 in 1000–2000 pregnancies are complicated by cancer Today different treatment options are considered as safe during pregnancy chemotherapy radiotherapy surgery or a combination of these Surgery is considered safe during all trimesters of pregnancy radiotherapy can be administered during the first and the second trimester and chemotherapy after the first trimester of pregnancy The placenta acting as a barrier between the mother and the fetus plays a key role in the safe administration of chemotherapy during pregnancy A few studies have investigated the short as well as the longterm health general development and cognitive and cardiac outcomes on children exposed to chemotherapy in utero In general these results were reassuring Nevertheless better safety data are required This means data with longer followup periods and comparison with appropriate control groups Moreover important biasing factors should be taken into account when interpreting these results Firstly a great proportion of children were born prematurely due to the maternal condition Preterm birth in general has been associated with cognitive impairment Secondly cancer during pregnancy is clearly a stressful situation and maternal stress is associated with attention deficits In sum we state that chemotherapy can be administered safely after the first trimester of pregnancy Moreover iatrogenic prematurity in order to start postpartum administration of chemotherapy should be avoided Nonetheless decisions concerning treatment in these specific cases should always be made in a multidisciplinary setting with internationally recognized expertise in the coexistence of cancer and pregnancy

Keywords: