BACKGROUND For female adolescent and young adult (AYA), cancer with treatments may affect their children's health. Our aim was to determine reliable risk estimates of adverse birth outcomes in AYA cancer survivors and the differential effects of treatments. METHODS The study population of 4547 births in the AYA cancer survivor group and 45,463 in the comparison group were identified from two national databases between 2004 and 2014. Detailed maternal health conditions, such as maternal comorbidities, medication use during pregnancy and lifestyles, were adjusted in the statistical analyses. The outcomes included low birth weight, preterm labour, stillbirth, small or large for gestational age, a 5-min Apgar score <7, congenital malformation and foetal distress. RESULTS The AYA cancer survivor group had a 9% higher risk of overall adverse birth outcomes (adjusted odds ratio, 1.09; 95% confidence interval, 1.02-1.16), especially low birth weight and preterm labour than the comparison group. The radiotherapy-only group additionally had a higher risk of foetal distress, and a 5-min Apgar score <7. CONCLUSION AYA cancer survivors, especially those who have received radiotherapy, still have higher risks of adverse birth outcomes after adjusting for detailed maternal health conditions. Preconception counselling and additional surveillance may be warranted in this population.

中文翻译：

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青春期和成年女性癌症幸存者的不良出生结局：一项基于全国的人口研究。

背景技术对于女性青少年和成人（AYA），接受治疗的癌症可能会影响其孩子的健康。我们的目标是确定AYA癌症幸存者中不良分娩结果的可靠风险估计以及治疗的不同效果。方法从2004年至2014年的两个国家数据库中，对AYA癌症幸存者组的4547例出生婴儿和对照组的45463例出生婴儿进行了研究。统计分析。结果包括低出生体重，早产，死产，胎龄大或小，5分钟Apgar得分<7，先天性畸形和胎儿窘迫。结果AYA癌症幸存者组的总体不良分娩结果风险高9％（校正比值比为1.09； 95％的置信区间为1.02-1.16），特别是低出生体重和早产。仅放疗组还有更高的胎儿窘迫风险，且5分钟Apgar评分<7。结论AYA癌症幸存者，尤其是那些接受放射治疗的幸存者，在调整了详细的孕产妇健康状况后，仍然有较高的不良分娩结果风险。该人群可能需要进行孕前咨询和额外的监视。5分钟Apgar得分<7。结论AYA癌症幸存者，尤其是那些接受放射治疗的幸存者，在调整了详细的孕产妇健康状况后，仍然有较高的不良分娩结果风险。该人群可能需要进行孕前咨询和额外的监视。5分钟Apgar得分<7。结论AYA癌症幸存者，尤其是那些接受放射治疗的幸存者，在调整了详细的孕产妇健康状况后，仍然有较高的不良分娩结果风险。该人群可能需要进行孕前咨询和额外的监视。