Association between reproductive cancer and fetal outcomes: a systematic review

Abstract

Objective: This study aimed to review studies that addressed the impact of previous reproductive cancer diagnosis on selected fetal birth outcomes.

Materials and methods: We searched PubMed and Web of Knowledge to identify peer-reviewed articles published from January 1992 to December 2012, investigating the association between reproductive cancer and birth outcomes. After applying exclusion criteria, 49 articles were identified for full review, and 36 articles were finally selected for this systematic review. The quality of the studies was assessed by independent reviewers.

Results: We found 13 cervical cancer studies, 16 ovarian cancer studies, and 7 corpus uteri cancers that reported subsequent pregnancies (n = 688 pregnancies in 477 women). Of these, 489 pregnancies reached third trimester. Among viable pregnancies, only 416 pregnancies had information on maturity status based on gestational age and/or birth weight. For those with cervical cancer, the preterm birth (PTB) rate was 48.5%. For those with ovarian cancer, there were no cases of PTB. For those with corpus uteri cancers, the PTB was 7.7%. All studies had small sample sizes, and there was considerable heterogeneity of results. Abortions, ectopic pregnancies, and terminations were also reported.

Conclusions: Reproductive cancers may be associated to subsequent adverse fetal birth outcomes; however, the quality of evidence is still insufficient to infer a relationship between reproductive cancers treated conservatively and adverse fetal birth outcomes in subsequent pregnancies.