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ABSTRACT: Assessment of fetal risk associated with exposure to
cancer chemotherapy during pregnancy: a multicenter study
The objective of the present study was to evaluate and quantify
fetal risks involved in the administration of cancer chemotherapy
during gestation, as well as to assess the long-term effects
on the exposed children.
In this retrospective, cohort study,
we reviewed the records of women aged 15 to 45 years with a
diagnosis of malignancy or benign tumors with malignant behavior
at three reference services in the State of Rio Grande do Sul,
Brazil, from 1990 to 1997.
All patients with a diagnosis of
pregnancy at any time during the course of the disease were
selected, regardless of whether or not they received specific
medication. Fetal outcomes of 14 pregnancies with chemotherapy
exposure were compared to that of 15 control pregnancies in which
these drugs were not used.
Long-term follow-up of the exposed
children was carried out. Fisher's exact test was used to compare
the groups. Continuous variables were compared by the
Wilcoxon-Mann-Whitney test. We found an increased rate of
prematurity (6/8 vs 2/10; RR: 3.75; CI: 1.02-13.8; P = 0.03)
in the exposed group.
There was a trend to an increased fetal
death rate (4/12 vs 0/10; P = 0.07) in the group exposed to
chemotherapy. No malformations were detected in any child,
which can be related to our small sample size as well as to
the fact that most exposures occurred after the first trimester
of pregnancy.
Other larger, controlled studies are needed to
establish the actual risk related to cancer chemotherapy during
pregnancy.
11/27/2001; Brazilian Journal of Medical and Biological Research
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