Cancer, chemotherapy prior to pregnancy do not increase stillbirth risk in adolescent and young adult women

Adolescent and young adult women diagnosed with cancer who received chemotherapy prior to pregnancy did not have an increased risk of stillbirth, according to a study led by Caitlin C. Murphy, PhD, MPH, with UTHealth Houston.

The study was recently published in the online version of the Journal of the National Cancer Institute.

There are very few studies of labor outcomes in adolescent and young adult women with cancer who later become pregnant. This study showed that cancer and chemotherapy do not appear to increase the risk of stillbirth and provides important information for women concerned about their ability to give birth after cancer.”

Caitlin C. Murphy, Associate Professor of Health Promotion and Behavioral Sciences at the UTHealth School of Public Health, Houston

For one of the paper’s co-authors, Andrea C. Betts, PhD, MPH, the findings were personal.

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“When I was pregnant with my first child, there was very little information available about how my previous cancer treatment might affect my child,” said Betts, a researcher at the school’s Dallas campus. “All my obstetrician could tell me was, ‘It’s plausible that there are increased risks.’ It is so rewarding to begin to fill this evidence gap and share good news with the many young women who are trying to have children after cancer.”

Some chemotherapy and radiation treatments have gonadotoxic effects, meaning they can damage eggs. Previous studies have shown that the health of the offspring could be affected. To test this theory, the study linked population-based data from the Texas Cancer Registry to live birth and fetal death certificates. They included 11,696 births in 8,402 women aged 15 to 39 diagnosed with cancer between 1995 and 2015 and compared them to the stillbirth rate in the general population. Stillbirth rates were similar in both groups, less than 1%.

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“It’s the best kind of clean sheet,” Murphy said.

Co-authors from the UTHealth School of Public Health included Betts, Marlyn A. Allicock, PhD, MPH, of the Dallas campus; L. Aubree Shay, PhD, MSW, of the San Antonio campus; and Sharice M. Preston, PhD, of the Houston campus.

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All are part of a research team in the Adolescent and Young Adult (AYA) Scholarship, Training, and Research (STAR) Lab established in 2020 at the UTHealth School of Public Health. Her expertise includes behavioral sciences, intervention development, epidemiology and programs assessment and health disparities.

Additional co-authors were Barbara A. Cohn, PhD, of the Public Health Institute in Berkeley, California; Philip J. Lupo, PhD, MPH, of Baylor College of Medicine; and Sandi L. Pruitt, PhD, MPH, of UT Southwestern Medical Center.


Magazine reference:

Murphy, C.C. et al. (2022) Stillbirth after cancer in adolescents and young adults: a population-based study. Journal of the National Cancer Institute.

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