THURSDAY, Feb. 9 (HealthDay News) -- A new study finds that the
babies of women who had chemotherapy while pregnant aren't at
higher risk for a variety of medical disorders, a sign that the
treatment should be safe for the fetus in most instances.
There's a caveat: babies born to pregnant women who had
chemotherapy were more likely to be born prematurely, potentially
putting them at risk for impaired brain development, which can
cause problems with memory, thinking and learning skills.
Still, the findings are "very good news," said maternal-fetal
medicine specialist Dr. Elyce Cardonick, who wrote a commentary
accompanying the study.
"No pregnant woman likes to choose between treating themselves and protecting the baby," said Cardonick, who works at Cooper Medical School of Rowan University in Camden, N.J. "They don't have to choose. By making themselves healthy, they're helping the baby."
An estimated one in 1,000 pregnant women have cancer, Cardonick
said. In some cases, doctors recommend that the women undergo
abortions. But chemotherapy is an option.
Typically, doctors only treat the women outside the early stages
of pregnancy and use older drugs that are "tried and true,"
Cardonick said.
Could chemotherapy harm the developing fetus? Previous research
has suggested it won't, but researchers led by Dr. Frederic Amant,
a gynecologic oncologist and assistant professor at Katholieke
Universiteit in Leuven, Belgium, sought to understand whether the
cancer treatment might affect babies after they are born.
In the new study, the researchers examined medical records and
test results of 70 children whose pregnant mothers underwent
chemotherapy. The children were followed for an average of 22
months and up to 18 years.
"The study is unique since this is the first time children were extensively examined over the long term," Amant said.
The investigators found that the children weren't at higher risk
of heart, hearing or nervous system disorders, or general health
and growth problems.
As to why the chemotherapy drugs do not reach the fetus and
cause harm, Amant said the placenta acts like a filter, keeping
most of the medications away from the fetus. Also, doctors avoid
chemotherapy in the first trimester, when organs are in the early
stages of development and especially vulnerable, Amant added.
The study is one of a series of articles about pregnant women
and cancer published online Feb. 10 in
The Lancet Oncology.
The other articles published in this issue report that:
- The current trend in medicine is to allow pregnancies to
continue in women diagnosed with cervical or ovarian cancer.
However, chemotherapy must not be used in the first eight weeks,
and the pregnancies come with risks.
- Pregnant women with breast cancer can undergo both surgery and
chemotherapy, all with the aim of a full-term pregnancy. The
mother's disease outcome would not be improved by terminating the
pregnancy.
- Blood cancer can cause complications in pregnant women, such as
blood clots, that may lead to advice to terminate the pregnancy at
an early stage to protect the health of the mother. But women in
later stages of pregnancy may find it feasible to undergo cancer
treatment while preserving the pregnancy.
More information
For more about
pregnancy and cancer, visit the American Society of Clinical Oncology.