Dataset Information

Pregnancy and neonatal outcomes among women with early-onset colorectal cancer: a nationwide case-control study.

ABSTRACT:

Background

Early-onset colorectal cancer has risen worldwide, leaving more women with colorectal cancer at reproductive ages. We aimed to investigate the risk of adverse pregnancy and neonatal outcomes among women with early-onset colorectal cancer.

Methods

We conducted a nationwide, matched case-control study of maternal/pregnancy outcomes including pre-eclampsia and Cesarean delivery (C-section) as well as neonatal outcomes including preterm birth among 207 births in women with early-onset colorectal cancer (ages 18-49) and 1019 births in women without colorectal cancer in Sweden (1992-2019). Early-onset colorectal cancer cases were identified through the Cancer Register, and outcome data were retrieved through linkage to Medical Birth Register and National Patient Register. Using conditional logistic regression, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

Findings

Between Jan 1, 1992, and Dec 31, 2019, women with early-onset colorectal cancer who gave birth had increased odds of pre-eclampsia (7.2% vs 3.2%; OR = 2.52, 95%CI = 1.25-5.08), any C-section (24.6% vs 19.4%; OR = 1.43, 95%CI = 1.00-2.06), particularly emergency C-section (17.4% vs 10.5%; OR = 1.79, 95%CI = 1.17-2.75), after adjustment for maternal education level, country of birth, body mass index and smoking in early pregnancy, and comorbidities. Maternal history of early-onset colorectal cancer was also associated with offspring preterm birth (12.1% vs 5.2%; OR = 2.31, 95%CI = 1.34-3.99), delineated as spontaneous (OR = 1.06, 95%CI = 0.47-2.39) or medically-indicated preterm birth (OR = 4.48, 95%CI = 2.05-9.79). There was no increased risk of congenital malformation or small for gestational age birth.

Interpretation

In this population-based study, maternal history of early-onset colorectal cancer was associated with risk of both adverse pregnancy (pre-eclampsia, C-section) and neonatal outcomes (preterm birth).

Funding

US National Institutes of Health, Swedish Society of Medicine, Swedish Cancer Foundation.

SUBMITTER: Cao Y

PROVIDER: S-EPMC10139893 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Publications

Pregnancy and neonatal outcomes among women with early-onset colorectal cancer: a nationwide case-control study.

Cao Yin Y Zhao Stephanie S Bexelius Tomas S TS Söderling Jonas J Shi Mengyao M Roelstraete Bjorn B Warner Barbara B BB Stephansson Olof O Ludvigsson Jonas F JF

EClinicalMedicine 20230413

<h4>Background</h4>Early-onset colorectal cancer has risen worldwide, leaving more women with colorectal cancer at reproductive ages. We aimed to investigate the risk of adverse pregnancy and neonatal outcomes among women with early-onset colorectal cancer.<h4>Methods</h4>We conducted a nationwide, matched case-control study of maternal/pregnancy outcomes including pre-eclampsia and Cesarean delivery (C-section) as well as neonatal outcomes including preterm birth among 207 births in women with ...[more]

PMID: 37125404

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Project description:IntroductionRecurrent pregnancy loss (RPL), defined as two or more pregnancy losses, might be associated with elevated obstetrical and perinatal risks in the following pregnancies. RPL and pregnancy problems related to placental development may have similar etiological features. This study explores the incidences of pregnancy and perinatal outcomes in women with RPL.Material and methodsThis retrospective case-control study investigated the outcomes of the next subsequent singleton pregnancy after thorough RPL examination (n = 360) in Helsinki University Hospital, Finland, in 2007-2016. Data for cases and four control women for each case, matched for age, parity, delivery month, year, and hospital (n = 1440), were retrieved from the Medical Birth Register. Primary outcomes were pregnancy and delivery complications, perinatal outcomes, and characteristics of pregnancy follow-up. Secondary outcomes were maternal and neonatal diagnoses. Associations between RPL and outcomes were estimated with risk ratios with 95% confidence intervals (CI). In sub-analyses, we compared the outcomes of secondary RPL with multipara controls and women with unexplained or explained RPL.ResultsWomen with RPL had a higher risk for gestational hypertension (3.1% vs. 1.4%, risk ratio [RR] 2.20 [Confidence interval (CI) 1.06-4.55], p = 0.03), preterm birth (8.9% vs. 5.8%, RR 1.54 [CI 1.04-2.28], p = 0.04), malpresentation of the fetus (3.3% vs. 1.5%, RR 2.18 [CI 1.09-4.37], p = 0.02), premature rupture of membranes (5.6% vs. 2.4%, RR 2.35 [CI 1.37-4.04], p = 0.002), and had more prenatal visits than controls. Mode of delivery was comparable between the study groups, although RPL women had more induced labor (28.1% vs. 22.2%, RR 1.26 [CI 1.04-1.53], p = 0.02). Mean birthweight was lower (3387 ± 680 g) in RPL women's newborns than in the control group (3482 ± 564 g, p = 0.02), and the risk of umbilical artery pH <7.10 (6.7% vs. 3.6%, RR 1.85 [CI 1.15-2.95], p = 0.03) was higher. Risk ratio for small for gestational age was higher in the secondary RPL group than in multipara controls (5.1% vs. 2.0%, RR 2.50 [CI 1.15-5.42], p = 0.02).ConclusionsWomen with a history of RPL seem to have higher risks in their subsequent pregnancies and should therefore be monitored carefully. These findings support the theory of placental development being the common nominator behind hypertensive pregnancy disorders and RPL.

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Dataset Information

Pregnancy and neonatal outcomes among women with early-onset colorectal cancer: a nationwide case-control study.

Background

Methods

Findings

Interpretation

Funding

Publications

Pregnancy and neonatal outcomes among women with early-onset colorectal cancer: a nationwide case-control study.

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