Table 1.
Odds ratios of pregnancy outcomes among female survivors of childhood cancer
| natural pregnancy outcome4 |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| live birth (n=2,998) | miscarriage (n=607) | still birth (n=23)5 | termination (n=485)6,7 | low birth weight (n=262)8 | premature (n=368) | |||||||
|
|
||||||||||||
| n (%) | OR (95%CI) | n (%) | OR (95%CI) | n (%) | OR (95%CI) | n (%) | OR (95%CI) | n (%) | OR (95%CI) | n (%) | OR (95%CI) | |
|
|
||||||||||||
| Type of childhood cancer 1 | ||||||||||||
| leukaemia (reference) |
549 (69.4%) | 1 | 132 (16.7%) | 1 | 5 (0.6%) | 1 | 105 (13.3%) | 1 | 33 (6.2%) | 1 | 62 (12.9%) | 1 |
| Hodgkin’s lymphoma |
251 (72.5%) | 1.2 (0.8,1.8) | 49 (14.2%) | 0.8 (0.5,1.3) | 3 (0.9%) | 1.4 (0.3,5.7) | 43 (12.4%) | 1.1 (0.7,1.8) | 13 (5.5%) | 1.0 (0.4,2.3) | 26 (11.6%) | 0.9 (0.5,1.6) |
| NHL | 156 (74.6%) | 1.4 (0.9,2.4) | 28 (13.4%) | 0.7 (0.4,1.2) | 0 | - | 25 (12.0%) | 1.2 (0.7,2.1) | 17 (11.1%) | 2.1 (1.0,4.8) | 18 (13.4%) | 1.1 (0.6,2.0) |
| CNS tumour | 577 (77.0%) | 1.5 (1.0,2.1) | 90 (12.0%) | 0.7 (0.5,0.9) | 5 (0.7%) | 1.0 (0.3,3.4) | 77 (10.3%) | 1.1 (0.8,1.7) | 27 (4.9%) | 0.8 (0.4,1.5) | 63 (13.4%) | 1.0 (0.6,1.6) |
| neuroblastoma | 139 (73.5%) | 1.4 (0.8,2.3) | 29 (15.3%) | 0.8 (0.5,1.2) | 0 | - | 21 (11.1%) | 1.1 (0.6,2.1) | 20 (15.4%) | 2.2 (1.1,4.6) | 21 (16.5%) | 1.5 (0.8,2.7) |
| NH-retinoblastoma | 213 (77.7%) | 1.5 (0.9,2.3) | 33 (12.0%) | 0.7 (0.4,1.1) | 2 (0.7%) | 1.1 (0.2,6.0) | 26 (9.5%) | 1.2 (0.7,2.1) | 15 (7.3%) | 1.2 (0.5,2.8) | 23 (12.1%) | 1.0 (0.5,1.7) |
| H-retinoblastoma | 83 (73.5%) | 1.5 (0.8,2.7) | 13 (11.5%) | 0.6 (0.3,1.2) | 1 (0.9%) | 1.4 (0.2,11.5) | 16 (14.2%) | 2.1 (1.1,3.7) | 4 (5.1%) | 0.8 (0.2,3.0) | 8 (10.4%) | 0.8 (0.3,1.7) |
| Wilms’ tumour | 248 (65.6%) | 1.0 (0.7,1.5) | 66 (17.5%) | 1.0 (0.6,1.5) | 4 (1.1%) | 1.8 (0.4,7.8) | 60 (15.9%) | 1.6 (1.0,2.4) | 56 (23.1%) | 3.9 (2.0,7.6) | 66 (30.1%) | 2.7 (1.7,4.3) |
| bone tumour | 180 (71.9%) | 1.2 (0.8,1.8) | 37 (14.9%) | 0.9 (0.6,1.4) | 0 | - | 31 (12.5% ) | 1.1 (0.7,1.8) | 18 (10.4%) | 2.3 (1.0,5.3) | 18 (11.5%) | 0.8 (0.4,1.6) |
| soft-tissue sarcoma | 241 (71.9%) | 1.0 (0.7,1.5) | 58 (17.3% ) | 1.0 (0.7,1.6) | 0 | - | 36 (10.8%) | 1.2 (0.8,2.0) | 25 (10.7%) | 2.9 (1.4,5.9) | 25 (12.3%) | 1.0 (0.6,1.7) |
| other | 361 (75.0%) | 1.2 (0.9,1.8) | 72 (15.0%) | 0.8 (0.6,1.2) | 3 (0.6%) | 0.9 (0.2,3.6) | 45 (9.4%) | 0.9 (0.6,1.4) | 34 (9.7%) | 2.2 (1.2,4.3) | 38 (12.5%) | 1.0 (0.6,1.5) |
| p-heterogeneity | 0.492 | 0.45 | - | 0.416 | <0.001 | <0.001 | ||||||
| Treated with chemotherapy 2 | ||||||||||||
| No (reference) | 1515 (75.4%) | 1 | 276 (13.7%) | 1 | 14 (0.7%) | 1 | 205 (10.2%) | 1 | 119 (8.2%) | 1 | 171 (13.6%) | 1 |
| Yes | 1035 (69.3%) | 0.8 (0.6,1.2) | 247 (16.5%) | 1.2 (0.9,1.7) | 7 (0.5%) | * | 204 (13.7%) | 0.8 (0.6,1.3) | 107 (10.7%) | 1.3 (0.8,2.2) | 142 (15.3%) | 1.2 (0.8,1.7) |
| Unknown | 448 (73.4%) | - | 84 (13.8%) | - | 2 (0.3%) | - | 76 (12.5%) | - | 36 (5.9%) | - | 55 (9.0%) | - |
| p-heterogeneity | 0.272 | 0.271 | - | 0.388 | 0.26 | 0.476 | ||||||
| Treated with radiotherapy 3 | ||||||||||||
| No (reference) | 1048 (73.7%) | 1 | 209 (14.7%) | 1 | 7 (0.5%) | 1 | 158 (11.1%) | 1 | 77 (7.6%) | 1 | 95 (10.5%) | 1 |
| Other (non-brain/abdominal) |
619 (75.5%) | 1.0 (0.8,1.4) | 107 (13.0%) | 1.0 (0.7,1.3) | 4 (0.5%) | 1.0 (0.3,3.4) | 90 (11.0%) | 1.1 (0.8,1.5) | 43 (7.4%) | 0.7 (0.4,1.2) | 71 (13.1%) | 1.2 (0.8,1.8) |
| Brain | 662 (72.7%) | 1.1 (0.8,1.4) | 130 (14.3%) | 0.9 (0.7,1.2) | 7 (0.8%) | 2.0 (0.6,6.9) | 112 (12.3%) | 0.8 (0.6,1.2) | 39 (6.2%) | 0.5 (0.3,0.8) | 82 (14.7%) | 1.3 (0.8,1.9) |
| Abdominal | 351 (69.0%) | 0.7 (0.5,1.0) | 96 (18.6%) | 1.4 (1.0,1.9) | 3 (0.6%) | 1.3 (0.2,7.2) | 59 (11.6%) | 1.1 (0.7,1.7) | 75 (22.3%) | 1.9 (1.1,3.2) | 90 (28.7%) | 3.2 (2.1,4.7) |
| Unknown | 318 (72.9%) | - | 65 (14.4%) | - | 2 (0.4%) | - | 66 (14.6%) | - | 28 (6.2%) | - | 30 (6.7%) | - |
| p-heterogeneity | 0.236 | 0.176 | - | 0.454 | <0.001 | <0.001 | ||||||
| Abdominal – Non- Wilms | 159 (71.6%) | 0.7 (0.5,1.1) | 40 (18.0%) | 1.5 (0.9,2.3) | 0 | * | 23 (10.4%) | 0.9 (0.5,1.6) | 30 (20.1%) | 1.6 (0.9,3.0) | 36 (25.0%) | 2.7 (1.6,4.5) |
| Abdominal – Wilms | 192 (66.9)% | 0.7 (0.5,1.1) | 56 (19.5%) | 1.4 (0.9,2.1) | 3 (1.1%) | * | 36 (12.5%) | 1.4 (0.8,2.4) | 45 (24.1%) | 2.3 (1.2,4.6) | 54 (31.8%) | 3.5 (2.1,5.7) |
| p-heterogeneity | 0.185 | 0.151 | .- | 0.457 | 0.028 | <0.001 | ||||||
1
Adjusted for maternal age and birth order
2
Adjusted for treatment with radiotherapy, maternal age, and birth order
3
Adjusted for treatment with chemotherapy , maternal age, and birth order
4
Outcomes evaluated relative to all natural pregnancy outcomes
5
Insufficient events to reliably test for heterogeneity
6
Evaluated relative to all natural pregnancy outcomes plus terminations
7
adjusted for decade of treatment
8
adjusted for premature delivery
NHL: Non-Hodgkin’s lymphoma; CNS: Central Nervous System; NH: non-heritable; H:heritable; RT: radiotherapy; CT: chemotherapy
*
Convergence not achieved