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In Utero Exposure to Cancer Treatment

By Lisa Schulmeister, RN, MN, APRN-BC, OCN, FAAN
Little is known about outcomes when cancer treatment occurs during pregnancy. Although women starting chemotherapy and/or radiotherapy are routinely advised to use birth control during treatment, some women already are pregnant or become pregnant during treatment. In two studies presented at the 2014 European Society for Medical Oncology meeting by Frederic Amant, MD, from the University Hospitals Leuven in Belgium, findings suggest that treatment during pregnancy does not appear to negatively impact neurologic or cardiac fetal development.

In the first study, 38 children exposed to chemotherapy in utero were recruited from the International Network for Cancer, Infertility and Pregnancy (INCIP) registry and assessed for mental development and cardiac health. Their outcomes were compared to 38 children who were not exposed to chemotherapy and served as the control group. At a median age of almost two, mental development (measured by the Mental Development Index) was in the normal range for both groups of children, and were not significantly different. Cardiac dimensions and functions were within normal ranges for both groups.

In the second study, Amant explored the impact of radiotherapy on the children of women with cancer. The study included 16 children and 10 adults who had been exposed to radiotherapy in utero. This is the first long-term follow-up study of children prenatally exposed to medical radiation, and findings suggest that neuropsychological, behavioral and general health outcomes for those exposed to radiotherapy were within normal ranges. One child had a severe cognitive delay; however; other pregnancy-related complications were confounding factors. The researchers concluded that this knowledge about outcomes may assist clinicians in counselling patients who are pregnant, or become pregnant, during treatment. More information is available here.
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