Because the ability to have children is an important concern for many survivors, this is one of the first areas we studied in the Long-Term Follow-Up Study. One of the key early findings of the study was that female survivors who are able to become pregnant have healthy, successful pregnancies at the same rate as the general population. Similarly, male survivors are able to father healthy, successful pregnancies. This was great news!
A landmark paper published in 2002 found that cancer treatment had little effect on the ability of most female survivors who become pregnant, to maintain a pregnancy or to deliver full-term babies. The study did find that women who’d received radiation treatment to the pelvis were at a slightly increased risk of delivering babies who were underweight at birth. A separate study found that the cancer treatments received by male survivors had little effect on the ability of their partners to have successful pregnancies, once they became pregnant.
LTFU researchers have continued to hone in on this important topic. In 2006 the LTFU study looked at birth characteristics of babies born to female survivors. This study also found that most survivors have successful pregnancies. The research team did find that, compared to siblings, survivors were more likely to deliver their babies before the expected due date (pre-term). In addition, survivors who had been treated with radiation to the pelvis were more likely to deliver preterm or low birth weight babies compared to survivors who did not receive radiation therapy.
A more recent LTFU study (January 2015) looked at the effects of emotional distress and lifestyle factors on pregnancy. The good news is that this study did not find a link between emotional stress/distress and bad pregnancy outcomes such as preterm birth, stillbirth, or miscarriage. However, the study showed that smoking before becoming pregnant was linked to an increased risk of having a miscarriage, particularly for survivors who had been treated with high doses of radiation to the uterus (pelvic area).
The results of these studies are reassuring – with few exceptions, survivors who are able to become pregnant (or father a pregnancy) have healthy pregnancies and successful deliveries. We hope these results will set survivors’ minds at ease so they can concentrate on practicing the healthy behaviors, like eating right and not smoking, that support healthy pregnancies, healthy parents, and healthy babies.
Citations
Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Green DM, Whitton JA, Stovall M, Mertens AC, Donaldson SS, Ruymann FB, Pendergrass TW, Robison LL. Am J Obstet Gynecol. 2002 Oct;187(4):1070-80.
Pregnancy outcome of partners of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Green DM, Whitton JA, Stovall M, Mertens AC, Donaldson SS, Ruymann FB, Pendergrass TW, Robison LL. J Clin Oncol. 2003 Feb 15;21(4):716-21.
Female survivors of childhood cancer: preterm birth and low birth weight among their children. Signorello LB, Cohen SS, Bosetti C, Stovall M, Kasper CE, Weathers RE, Whitton JA, Green DM, Donaldson SS, Mertens AC, Robison LL, Boice JD Jr. J Natl Cancer Inst. 2006 Oct 18;98(20):1453-61.
Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort. Gawade PL, Oeffinger KC, Sklar CA, Green DM, Krull KR, Chemaitilly W, Stovall M, Leisenring W, Armstrong GT, Robison LL, Ness KK. Am J Obstet Gynecol. 2015 Jan;212(1):47.e1-10.