Cancer during pregnancy means compromising the health of either the mother or the foetus – or so we used to be told. Now it appears that treatment during pregnancy may be safe for both parties, as long as it is not undertaken during the first 12 weeks of pregnancy.
A recent cohort study on subjects in cancer referral clinics in Belgium, The Netherlands, Canada and the Czech Republic followed children born to mothers who had had chemotherapy during pregnancy. The study considered both pregnant women undergoing chemotherapy at the time of the study and children born before the study commenced, so the children ranged in age from 18 months to 18 years. None of the treatments had started during the 1st trimester. The 70 children were initially followed for 22 months and will be re-assessed later.
All the mothers had been treated using various forms of chemotherapy; some had also had radiotherapy and/or surgery.
The children were examined on their general health, brain and heart function, hearing and cognitive development and compared to national norms for children of similar ages. Most of those assessed were born prematurely (average 35.7 weeks) and received lower than normal IQ scores, which suggested to the researchers that planned premature delivery was unhelpful to the babies’ development.
Some of the children showed higher than average behavioural problems, which could point to subtle effects of chemotherapy on neurodevelopment. Other health scores were within national norms, suggesting that cancer treatment is on the whole safe during 2nd and 3rd trimester pregnancy and need not be delayed, risking the mother’s health in an attempt to protect the unborn child.
Clearly a study group of just 70 children does not give a conclusive result, and the study is continuing with a wider sample which will also consider the longer-term effects of maternal cancer treatment on the health of the children. However the results from this limited study seem largely positive for both mother and child.