Counseling and surveillance of obstetrical risks for female childhood, adolescent, and young adult cancer survivors: recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

DOI

  • Anne Lotte Lolkje Femke van der Kooi, Erasmus University Rotterdam, Princess Maxima Center for Pediatric Oncology
  • ,
  • Renee L. Mulder, Princess Maxima Center for Pediatric Oncology
  • ,
  • Melissa M. Hudson, St. Jude Children Research Hospital
  • ,
  • Leontien C.M. Kremer, Princess Maxima Center for Pediatric Oncology, University of Amsterdam
  • ,
  • Rod Skinner, Newcastle University
  • ,
  • Louis S. Constine, University of Rochester
  • ,
  • Wendy van Dorp, Erasmus University Rotterdam
  • ,
  • Eline van Dulmen-den Broeder, Princess Maxima Center for Pediatric Oncology, University of Amsterdam
  • ,
  • Jeanette Falck-Winther
  • W. Hamish Wallace, Royal Hospital for Sick Children
  • ,
  • Jason Waugh, The University of Auckland
  • ,
  • Teresa K. Woodruff, Northwestern University
  • ,
  • Richard A. Anderson, University of Edinburgh
  • ,
  • Saro H. Armenian, City of Hope National Med Center
  • ,
  • Kitty W.M. Bloemenkamp, Utrecht University
  • ,
  • Hilary O.D. Critchley, University of Edinburgh
  • ,
  • Charlotte Demoor-Goldschmidt, Universite d'Angers, Univ Paris 11, University of Paris Sud - Paris XI, IDES, UMR 8148
  • ,
  • Matthew J. Ehrhardt, St. Jude Children Research Hospital
  • ,
  • Daniel M. Green, St. Jude Children Research Hospital
  • ,
  • William A. Grobman, Northwestern University
  • ,
  • Yuriko Iwahata, Northwestern University, St. Marianna University School of Medicine
  • ,
  • Iris Krishna, Emory University
  • ,
  • Joop S.E. Laven, Erasmus University Rotterdam
  • ,
  • Gill Levitt, UCL Great Ormond Street Institute of Child Health
  • ,
  • Lillian R. Meacham, Emory University
  • ,
  • Emily S. Miller, Northwestern University
  • ,
  • Annemarie Mulders, Erasmus University Rotterdam
  • ,
  • Angela Polanco, University Hospitals Coventry and Warwickshire NHS Trust
  • ,
  • Cécile M. Ronckers, Princess Maxima Center for Pediatric Oncology, Brandenburg Medical School
  • ,
  • Amber Samuel, Conroe Regional Medical Center
  • ,
  • Tom Walwyn, Perth Children's Hospital
  • ,
  • Jennifer M. Levine, Cornell University
  • ,
  • Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology

Female childhood, adolescent, and young adult cancer survivors have an increased risk of adverse pregnancy outcomes related to their cancer- or treatment-associated sequelae. Optimal care for childhood, adolescent, and young adult cancer survivors can be facilitated by clinical practice guidelines that identify specific adverse pregnancy outcomes and the clinical characteristics of at-risk subgroups. However, national guidelines are scarce and vary in content. Here, the International Late Effects of Childhood Cancer Guideline Harmonization Group offers recommendations for the counseling and surveillance of obstetrical risks of childhood, adolescent, and young adult survivors. A systematic literature search in MEDLINE database (through PubMed) to identify all available evidence published between January 1990 and December 2018. Published articles on pregnancy and perinatal or congenital risks in female cancer survivors were screened for eligibility. Study designs with a sample size larger than 40 pregnancies in childhood, adolescent, and young adult cancer survivors (diagnosed before the age of 25 years, not pregnant at that time) were eligible. This guideline from the International Late Effects of Childhood Cancer Guideline Harmonization Group systematically appraised the quality of available evidence for adverse obstetrical outcomes in childhood, adolescent, and young adult cancer survivors using Grading of Recommendations Assessment, Development, and Evaluation methodology and formulated recommendations to enhance evidence-based obstetrical care and preconception counseling of female childhood, adolescent, and young adult cancer survivors. Healthcare providers should discuss the risk of adverse obstetrical outcomes based on cancer treatment exposures with all female childhood, adolescent, and young adult cancer survivors of reproductive age, before conception. Healthcare providers should be aware that there is no evidence to support an increased risk of giving birth to a child with congenital anomalies (high-quality evidence). Survivors treated with radiotherapy to volumes exposing the uterus and their healthcare providers should be aware of the risk of adverse obstetrical outcomes such as miscarriage (moderate-quality evidence), premature birth (high-quality evidence), and low birthweight (high-quality evidence); therefore, high-risk obstetrical surveillance is recommended. Cardiomyopathy surveillance is reasonable before pregnancy or in the first trimester for all female survivors treated with anthracyclines and chest radiation. Female cancer survivors have increased risks of premature delivery and low birthweight associated with radiotherapy targeting the lower body and thereby exposing the uterus, which warrant high-risk pregnancy surveillance.

OriginalsprogEngelsk
TidsskriftAmerican Journal of Obstetrics and Gynecology
Vol/bind224
Nummer1
Sider (fra-til)3-15
Antal sider13
ISSN0002-9378
DOI
StatusUdgivet - jan. 2021

Bibliografisk note

Funding Information:
We thank the following people for critically appraising the recommendations and the manuscript: Melanie Davies, Michael Hawkins, Ann Partridge, and Lisa Webber (expert panel) and Eline van der Meulen and Katie Weyer (patient advocates).

Publisher Copyright:
© 2020 The Authors

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Se relationer på Aarhus Universitet Citationsformater

ID: 212850835