Abstract
Several studies on pregnancy-associated cancers have suggested an association with congenital anomalies in offspring. Previous studies have included maternal cancers diagnosed up to 2 years after pregnancy; however, long latency periods of some cancers mean that cancers diagnosed many years postpartum might have been present during pregnancy in a preclinical state. This paper considers the association between maternal cancers diagnosed from 2 years prior to pregnancy until the mother reaches 50 years of age, and congenital anomalies, as diagnosed at birth or within the first year of life. The current population-based study looks at associations of cancers in mothers with congenital anomalies in their children. Children were followed up from birth to diagnosis of a congenital anomaly, death, emigration or end of follow-up (whichever occurred first). A total of 56,016 children (2.6%) were considered exposed to a maternal cancer of any type; and they had a hazard ratio (HR) of 1.04 (95% confidence interval [CI]: 1.00, 1.09) compared with unexposed children. The greatest HR was seen among children whose mothers had been diagnosed with cancers before or during pregnancy (HR: 1.37, 95% CI: 1.07, 1.75). Similar results were seen when paternal cancers were used as a ‘negative control’. Statistically significant associations were seen for some specific congenital anomalies of organ systems (congenital anomalies of the musculoskeletal system [HR: 1.13, 95% CI: 1.02, 1.25]) and for some specific types of maternal cancer (leukaemia [HR: 1.31, 95% CI: 1.01, 1.61], The results of the main analyses suggest a small increase in risk of congenital anomalies in offspring of mothers diagnosed with cancer from 2 years before pregnancy, until the mother reaches 50 years of age; with the greatest increase seen for exposure in the pre-pregnancy and pregnancy period. These results may reflect shared causes for some cancers and some congenital anomalies. The similar results seen for paternal cancers indicate that the cause may be genetic or related to the families’ social and environmental conditions.
Highlights
The prevalence of pregnancy-associated cancers is estimated at 1 in 1000 to 1 in 1500 of pregnancies [1,2,3,4]
Of the 95,815 children with a congenital anomaly registered before 1 year of age, 9,408 (9.8%) had a sibling who had a congenital anomaly registered prior 1 year of age; and 9,568 (10.0%) had more than one anomaly registered in their first year
Fewer exposed children were seen in the lowest tertile for maternal income; there were more missing data among the exposed, especially for socioeconomic variables
Summary
The prevalence of pregnancy-associated cancers is estimated at 1 in 1000 to 1 in 1500 of pregnancies [1,2,3,4]. Cancers diagnosed during or shortly after pregnancy, within one or two years after childbirth are considered to be pregnancy-associated cancers [5,6,7,8]; but, long periods can pass between an exposure initiating the growth of an abnormal cell, invasion of the cancer, symptoms becoming apparent, and a diagnosis and treatment being made. It is possible that some cancers have even longer induction and latency times than these. Cancers diagnosed postpartum may have been initiated, but remained undetected, during pregnancy, possibly affecting the developing fetus. Pregnancy-associated cancers, in this paper, are defined as all cancers diagnosed from 2 years prior to pregnancy and up to 50 years of age in the mothers
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