The study, led by Dr. Pallavi D. Dhabekar from the Department of Community Medicine, SMBT Institute of Medical Sciences and Research Centre, Nashik, India, and colleagues, highlights the long-term reproductive and
maternal health implications of cancer and its treatment in young females.
The researchers noted that although many young women successfully conceive after cancer therapy, the potential impact of prior malignancy and treatment-related damage on maternal and fetal health remains a critical concern. To evaluate this, the team conducted an extensive literature review, including studies published up to December 2024. The analysis focused on women diagnosed with any form of cancer before the age of 39 and compared their pregnancy outcomes with those of women without a cancer history.
After screening and removing duplicates using NESTED Knowledge, 40 studies were deemed eligible, of which 37 were included in the meta-analysis. Using a random effects model and maximum likelihood estimators, the pooled data provided compelling evidence of elevated risks across several obstetric and feto-maternal outcomes among cancer survivors.
Key Findings:
- Survivors had a 30% higher risk of preterm birth (RR 1.30) compared with women without a cancer history.
- The risk of gestational diabetes mellitus was 32% higher in the cancer survivor group (RR 1.32).
- The likelihood of congenital anomalies among offspring was 13% higher in cancer survivors (RR 1.13).
In addition to these findings, cesarean deliveries were also more common among women with a cancer history, suggesting that medical teams may opt for surgical births due to potential complications or heightened maternal-fetal risk. Despite these associations, the researchers rated the certainty of evidence as “very low” across all outcomes based on the GRADE profile, indicating the need for further high-quality studies to validate the results.
According to Dr. Dhabekar and her team, these findings underscore the importance of specialized preconception counseling and close antenatal monitoring for female cancer survivors. Oncologists and obstetricians should work collaboratively to identify women at higher risk and provide individualized care plans to ensure safer pregnancies and better outcomes for both mothers and their babies.
The study highlights that while advances in cancer therapy have significantly improved survival rates among young women, attention must now turn to their long-term reproductive health. As more survivors enter reproductive age, proactive screening, multidisciplinary care, and awareness of potential complications will be essential in improving obstetric outcomes in this vulnerable population.
Reference:
Dhabekar, P. D., Srivastava, N., Deshmukh, K., Saravanan, K., Dayama, S., Tyagi, S., Yadav, A., & Gandhi, A. P. Association between the female survivors of childhood, adolescent, and young adult cancer and the adverse obstetric and feto-maternal outcomes: A systematic review and meta-analysis. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.70583
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