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Author Notes:

Kathleen P. Hartnett, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, CNR 3rd Floor, Atlanta, GA 30322. Tel: +01-4047273956, Fax: +01-4047278737, kchap01@emory.edu.

The authors are grateful to Lyn Almon at the Georgia Cancer Registry, who linked the data to Georgia vital records and worked with other states to facilitate the link and standardize linking methodologies.

We would also like to thank Rana Bayakly, James Steiner, and Gordon Freymann at the Georgia Department of Public Health, Gary Leung, Soundarya Radhakrishnan, and Chandrika Rao at the North Carolina Central Cancer Registry, Matt Avery and Eleanor Howell at the North Carolina Center for Health Statistics, Jake Richards and Martin Whiteside at the Tennessee Cancer Registry, and Benjamin Crumpler at the Tennessee Office of Vital Statistics, who worked to provide the linked datasets and made this study possible.


Research Funding:

Funding for this research was provided by The Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant 1R01HD066059, the Reproductive, Perinatal & Pediatric Training Grant T32HD052460, Laney Graduate School at Emory University, and the Achievement Rewards for College Scientists (ARCS) Foundation Atlanta chapter.

Infrastructure funding for state cancer registries is provided by cooperative agreement award numbers 5NU58DP00387504 to Georgia, 5U58DP00393305 to North Carolina, and 5U58DP003901 to Tennessee from the Centers for Disease Control and Prevention and through contract HHSN261201300015I with the National Cancer Institute.

The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the National Cancer Institute.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • cancer survivor
  • pregnancy
  • birth outcome

The risk of preterm birth and growth restriction in pregnancy after cancer


Journal Title:

International Journal of Cancer


Volume 141, Number 11


, Pages 2187-2196

Type of Work:

Article | Post-print: After Peer Review


It is unclear whether cancer and its treatments increase the risk of adverse pregnancy outcomes. Our aim was to examine whether cancer survivors have higher risks of poor outcomes in pregnancies conceived after diagnosis than women without cancer, and whether these risks differ by cancer type and race. Diagnoses from cancer registries were linked to pregnancy outcomes from birth certificates in three U.S. states. Analyses were limited to the first, live singleton birth conceived after diagnosis. Births to women without a previous cancer diagnosis in the registry were matched to cancer survivors on age at delivery, parity, race/ethnicity and education. Log-binomial regression was used to estimate risk ratios. Cervical cancer survivors had higher risks of preterm birth (Risk ratio = 2.8, 95% Confidence interval: 2.1, 3.7), as did survivors of invasive breast cancer (RR = 1.3, 95% CI: 1.1, 1.7) and leukemia (RR = 2.1, 95% CI: 1.3, 3.5). We observed a higher risk of small for gestational age (SGA) infants (<10% of weight for age based on a national distribution) in survivors of brain cancer (RR = 1.7, 95% CI: 1.1, 2.8) and extranodal non-Hodgkin lymphoma (RR = 2.3, 95% CI: 1.5, 3.6). We did not see an increased risk of infants born preterm, low birth weight, or SGA in pregnancies conceived after ductal carcinoma in situ, thyroid cancer, melanoma, or Hodgkin lymphoma. While our results are reassuring for survivors of many cancers, some will need closer monitoring during pregnancy.

Copyright information:

© 2017 UICC

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