Table 3.

Relative risk of receiving maternal care for problems relating to the fetus, amniotic cavity, and possible delivery problems among female survivors of childhood cancer

Characteristic	Maternal care related to:
	Malpresentation of fetus* ICD10: O32			Uterine scar from previous surgery*,† ICD10: O34.2			Fetal problems*,‡ ICD10: O36			Premature rupture of membranes* ICD10: O42			Prolonged (post-term) pregnancy*,§,‖ ICD10: O48
	No. (%)	RR (95% CI)	P¶	No. (%)	RR (95%CI)	P¶	No. (%)	RR (95% CI)	P¶	No. (%)	RR (95% CI)	P¶	No. (%)	RR (95% CI)	P¶
General population	1058 (4.2)	1.00 (ref.)		1699 (6.8)	1.00 (ref.)		1431 (5.7)	1.00 (ref.)		1913 (7.7)	1.00 (ref.)		1349 (5.4)	1.00 (ref.)
Female survivors#	41 (4.8)	1.08 (0.78 to 1.62)	.42	76 (8.8)	1.23 (0.98 to 1.56)	.09	53 (6.2)	1.08 (0.82 to 1.41)	.65	54 (6.3)	0.83 (0.63 to 1.09)	.15	50 (5.8)	1.12 (0.82 to 1.49)	.50
Type of childhood cancer
Leukemia	47 (5.1)	1.00 (ref.)		86 (9.4)	1.00 (ref.)		67 (7.3)	1.00 (ref.)		81 (8.9)	1.00 (ref.)		66 (7.2)	1.00 (ref.)
Hodgkin lymphoma	9 (5.9)	1.10 (0.50 to 2.45)	.81	11 (7.2)	0.53 (0.23 to 1.20)	.13	11 (7.2)	1.00 (0.50 to 2.01)	.99	17 (11.1)	1.17 (0.73 to 1.89)	.51	7 (4.6)	0.59 (0.26 to 1.36)	.24
Non-Hodgkin lymphoma	4 (3.6)	0.66 (0.25 to 1.76)	.41	13 (11.7)	1.06 (0.59 to 1.92)	.84	7 (6.3)	0.87 (0.38 to 2.01)	.75	10 (9.0)	0.98 (0.51 to 1.88)	.94	6 (5.4)	0.74 (0.34 to 1.64)	.44
CNS tumor	19 (5.7)	1.04 (0.60 to 1.78)	.89	34 (10.1)	1.10 (0.75 to 1.62)	.62	20 (6.0)	0.81 (0.48 to 1.37)	.43	24 (7.1)	0.75 (0.49 to 1.15)	.19	22 (6.5)	0.84 (0.54 to 1.44)	.48
Neuroblastoma	4 (3.0)	0.62 (0.22 to 1.69)	.35	11 (8.1)	0.98 (0.51 to 1.86)	.95	15 (11.1)	1.48 (0.84 to 2.61)	.18	12 (8.9)	1.04 (0.57 to 1.90)	.91	2 (1.5)	0.16 (0.06 to 0.90)	.04
NH-retinoblastoma	4 (2.8)	0.50 (0.18 to 1.35)	.17	10 (7.0)	0.80 (0.43 to 1.46)	.46	6 (4.2)	0.59 (0.26 to 1.33)	.21	10 (7.0)	0.76 (0.41 to 1.43)	.40	12 (8.4)	1.13 (0.61 to 2.12)	.70
H-retinoblastoma	4 (6.9)	1.43 (0.54 to 3.81)	.47	2 (3.4)	0.36 (0.05 to 2.51)	.30	2 (3.4)	0.42 (0.11 to 1.60)	.20	3 (5.2)	0.56 (0.19 to 1.64)	.29	5 (8.6)	1.23 (0.53 to 2.84)	.65
Wilms tumor	18 (5.6)	1.11 (0.65 to 1.89)	.70	29 (9.0)	0.97 (0.63 to 1.50)	.89	30 (9.3)	1.35 (0.86 to 2.10)	.19	23 (7.1)	0.78 (0.50 to 1.23)	.29	11 (3.4)	0.52 (0.28 to 0.94)	.02
Bone tumor	6 (4.1)	0.81 (0.35 to 1.86)	.62	12 (8.3)	0.96 (0.54 to 1.69)	.89	5 (3.4)	0.49 (0.20 to 1.20)	.12	12 (8.3)	0.90 (0.49 to 1.65)	.72	8 (5.5)	0.74 (0.34 to 1.64)	.45
Soft-tissue sarcoma	9 (4.9)	0.94 (0.44 to 2.01)	.87	17 (9.2)	0.86 (0.51 to 1.45)	.57	13 (7.0)	0.95 (0.54 to 1.68)	.87	12 (6.5)	0.70 (0.37 to 1.33)	.27	15 (8.1)	1.04 (0.60 to 1.94)	.88
Other	13 (4.6)	0.88 (0.46 to 1.66)	.69	27 (9.6)	0.92 (0.58 to 1.44)	.71	12 (4.3)	0.61 (0.33 to 1.13)	.12	18 (6.4)	0.70 (0.42 to 1.16)	.16	11 (3.9)	0.48 (0.25 to 0.98)	.04
Pheterogeneity¶			.89			.90			.15			.72			.12
Treated with radiotherapy
No	41 (4.8)	1.00 (ref.)		76 (8.8)	1.00 (ref.)		53 (6.2)	1.00 (ref.)		54 (6.3)	1.00 (ref.)		50 (5.8)	1.00 (ref.)
Brain	48 (5.3)	1.12 (0.73 to 1.72)	.60	86 (9.5)	1.15 (0.84 to 1.57)	.38	70 (7.8)	1.24 (0.86 to 1.79)	.25	82 (9.1)	1.49 (1.07 to 2.08)	.02	64 (7.1)	1.19 (0.82 to 1.76)	.30
Other (nonbrain/abdominal)	12 (5.2)	1.05 (0.52 to 2.10)	.90	16 (6.9)	0.66 (0.36 to 1.18)	.16	16 (6.9)	1.13 (0.65 to 1.97)	.67	19 (8.2)	1.27 (0.77 to 2.09)	.35	14 (6.1)	0.85 (0.46 to 1.75)	.77
Abdominal	17 (5.2)	1.07 (0.62 to 1.85)	.82	38 (11.7)	1.31 (0.88 to 1.93)	.18	24 (7.4)	1.26 (0.78 to 2.03)	.35	21 (6.4)	1.01 (0.61 to 1.68)	.96	18 (5.5)	0.94 (0.54 to 1.64)	.79
Abdominal non-Wilms	4 (3.4)	0.66 (0.24 to 1.81)	.42	15 (12.6)	1.41 (0.83 to 2.40)	.21	6 (5.0)	0.80 (0.32 to 2.04)	.65	9 (7.6)	1.18 (0.56 to 2.45)	.67	8 (6.7)	1.06 (0.54 to 2.29)	.86
Abdominal Wilms only	13 (6.3)	1.33 (0.72 to 2.43)	.36	23 (11.1)	1.26 (0.79 to 2.02)	.33	18 (8.7)	1.47 (0.88 to 2.47)	.14	12 (5.8)	0.93 (0.51 to 1.70)	.83	10 (4.8)	0.84 (0.44 to 1.64)	.58
No radiotherapy Wilms only	5 (5.2)	1.15 (0.46 to 2.91)	.76	6 (6.3)	0.82 (0.32 to 2.14)	.69	9 (9.4)	1.68 (0.75 to 3.79)	.21	8 (8.3)	1.47 (0.69 to 3.15)	.32	1 (1.0)	0.19 (0.03 to 1.36)	.10
Pheterogeneity¶			.96			.14			.66			.09			.58
Age at diagnosis, y
0–4	65 (4.9)	1.00 (ref.)		114 (8.7)	1.00 (ref.)		100 (7.6)	1.00 (ref.)		100 (7.6)	1.00 (ref.)		71 (6.3)	1.00 (ref.)
5–9	37 (4.7)	0.88 (0.54 to 1.43)	.61	69 (8.8)	0.89 (0.62 to 1.27)	.51	56 (7.2)	1.07 (0.72 to 1.60)	.73	71 (9.1)	1.29 (0.91 to 1.83)	.15	48 (7.0)	1.24 (0.78 to 1.97)	.36
10–14	35 (5.1)	0.72 (0.39 to 1.33)	.30	69 (10.0)	0.92 (0.62 to 1.37)	.67	32 (4.7)	0.78 (0.47 to 1.30)	.35	51 (7.4)	0.92 (0.58 to 1.46)	.74	41 (7.0)	1.32 (0.77 to 2.27)	.32
Ptrend¶			.30			.63			.46			.99			.29
Decade of diagnosis
<1980	49 (5.8)	1.00 (ref.)		112 (13.2)	1.00 (ref.)		58 (6.8)	1.00 (ref.)		58 (6.8)	1.00 (ref.)		46 (6.7)	1.00 (ref.)
1980–1984	39 (4.8)	0.93 (0.56 to 1.55)	.78	74 (9.1)	0.72 (0.51 to 1.02)	.07	54 (6.7)	1.07 (0.67 to 1.73)	.77	65 (8.0)	1.23 (0.82 to 1.84)	.32	59 (8.4)	1.34 (0.82 to 2.20)	.24
1985–1991	41 (4.1)	0.87 (0.46 to 1.64)	.66	57 (5.8)	0.52 (0.33 to 0.81)	<.001	67 (6.8)	1.10 (0.65 to 1.88)	.72	91 (9.2)	1.35 (0.85 to 2.16)	.21	53 (6.0)	0.97 (0.53 to 1.80)	.93
Ptrend¶			.66			.004			.72			.22			.76

^*Adjusted for maternal age and parity. CNS = central nervous system; H = heritable; ICD = International Classification of Diseases, version 10; NH = nonheritable; RR = relative risk.

^†Includes maternal care due to scar previous cesarean section.

^‡Includes maternal care for rhesus isoimmunization, maternal care for poor fetal growth, maternal care for excessive fetal growth.

^§Deliveries via elective cesarean section excluded.

^‖Pregnancies that progressed beyond 42 weeks of gestation.

^¶P values were calculated using a two-sided Wald’s test.

^#Relates to all female survivors not treated with any radiotherapy.