Study suggests chemotherapy during pregnancy won't affect baby
Women who underwent chemotherapy while pregnant need not worry about whether the treatment affected their babies, new research from Europe suggests. Scientists in Belgium, the Czech Republic and the Netherlands have discovered that the development of the babies' mental processes as well as the normal functioning of their hearts remains intact. The results of the study were presented at the recent European Multidisciplinary Cancer Congress in Berlin, Germany.
'To the best of our knowledge, this is the first time that children of 18 months and older have been examined after chemotherapy during pregnancy,' says Professor Frederic Amant of the University Hospitals Leuven in Belgium, 'and the news is reassuring in respect of the effects of chemotherapy on cognitive and cardiac outcomes.'
He goes on to say that while 47 of the 70 children born from 68 pregnancies were delivered preterm, it was prematurity rather than chemotherapy that impacted the children's cognitive development. Working together with colleagues from the Czech Republic and the Netherlands, Professor Amant began to recruit children for the study in 2005. The children were born in the periods spanning 1991 to 2004 and 2005 to 2010, with their ages ranging from 18 months to 18 years. The team assessed the children at birth, and again at the ages of 18 months, 5 to 6 years, 8 to 9 years, 11 to 12 years, 15 to 16 years, and 18 years. The scientists also kept an eye on the children's health over a 2-year period; some children were also monitored for up to 18 years.
During their pregnancies, the 68 women diagnosed with different cancers were treated with chemotherapy, either on its own, or in combination with radiotherapy or surgery or both. Breast cancer was the most common, with 35 women suffering from it, followed by haematological cancers such as leukaemia and lymphomas (18 women), ovarian cancer (6 women), cervical cancer (4 women), and others like brain, skin, colorectal, nasopharyngeal and Ewing's Sarcoma (cancer in bone or soft tissues).
The team collated information about the mothers' treatment and medical history. They later evaluated the general health of the children, as well as their school performance and sporting activity, if any. The family's social situation was also taken into consideration.
The researchers assessed the development of the children's mental processes by looking specifically at their intelligence, verbal and non-verbal memory, working memory, attention and executive functions (i.e. how well the children could control and regulate other abilities and behaviours). The parents were asked to fill out a questionnaire on the children's behavioural and emotional troubles.
'Our results so far suggest that children who were prenatally exposed to chemotherapy seem to do as well as children in the general population, and, that the treatment does not influence the development of mental processes or the functioning of the heart in the children we have followed for an average of 22 months,' Professor Amant says.
'We believe these results do allow us to make a recommendation about chemotherapy in pregnancy: pregnant women with cancer do not need to delay their cancer treatment or terminate their pregnancy. The benefits of chemotherapy to the mothers outweigh any potential long-term harm to the children.'
But he points out that everything should be done to ensure that the baby is carried to full term, at least 37 weeks, since the findings suggest that children suffer more from prematurity than from prenatal chemotherapy.
'Pregnant women who are receiving chemotherapy often have delivery induced from the moment the foetus is viable, [even though it is] not mature,' the Belgian researcher says. 'Our results suggest this should be avoided.'
Commenting on future plans, Professor Amant says: 'At this stage we do not know the full, long-term consequences of prenatal chemotherapy, including its effect on the children's fertility and likelihood of developing cancers when they are older. For this reason, we are continuing this international collaboration to follow-up more children for longer periods of time.'
University Hospitals Leuven
European Cancer Organisation
'Breast cancer tumours change as disease progresses'