Chemo During Pregnancy Doesn’t Seem to Harm Baby

THURSDAY, Feb. 9 (HealthDay News) — A new study finds that the
babies of women who had chemotherapy while pregnant aren’t at higher risk
for a variety of medical disorders, a sign that the treatment should be
safe for the fetus in most instances.

There’s a caveat: babies born to pregnant women who had chemotherapy
were more likely to be born prematurely, potentially putting them at risk
for impaired brain development, which can cause problems with memory,
thinking and learning skills.

Still, the findings are “very good news,” said maternal-fetal medicine
specialist Dr. Elyce Cardonick, who wrote a commentary accompanying the
study.

“No pregnant woman likes to choose between treating themselves and
protecting the baby,” said Cardonick, who works at Cooper Medical School
of Rowan University in Camden, N.J. “They don’t have to choose. By making
themselves healthy, they’re helping the baby.”

An estimated one in 1,000 pregnant women have cancer, Cardonick said.
In some cases, doctors recommend that the women undergo abortions. But
chemotherapy is an option.

Typically, doctors only treat the women outside the early stages of
pregnancy and use older drugs that are “tried and true,” Cardonick
said.

Could chemotherapy harm the developing fetus? Previous research has
suggested it won’t, but researchers led by Dr. Frederic Amant, a
gynecologic oncologist and assistant professor at Katholieke Universiteit
in Leuven, Belgium, sought to understand whether the cancer treatment
might affect babies after they are born.

In the new study, the researchers examined medical records and test
results of 70 children whose pregnant mothers underwent chemotherapy. The
children were followed for an average of 22 months and up to 18 years.

“The study is unique since this is the first time children were
extensively examined over the long term,” Amant said.

The investigators found that the children weren’t at higher risk of
heart, hearing or nervous system disorders, or general health and growth
problems.

As to why the chemotherapy drugs do not reach the fetus and cause harm,
Amant said the placenta acts like a filter, keeping most of the
medications away from the fetus. Also, doctors avoid chemotherapy in the
first trimester, when organs are in the early stages of development and
especially vulnerable, Amant added.

The study is one of a series of articles about pregnant women and
cancer published online Feb. 10 in The Lancet Oncology.

The other articles published in this issue report that:

  • The current trend in medicine is to allow pregnancies to continue in
    women diagnosed with cervical or ovarian cancer. However, chemotherapy
    must not be used in the first eight weeks, and the pregnancies come with
    risks.
  • Pregnant women with breast cancer can undergo both surgery and
    chemotherapy, all with the aim of a full-term pregnancy. The mother’s
    disease outcome would not be improved by terminating the pregnancy.
  • Blood cancer can cause complications in pregnant women, such as blood
    clots, that may lead to advice to terminate the pregnancy at an early
    stage to protect the health of the mother. But women in later stages of
    pregnancy may find it feasible to undergo cancer treatment while
    preserving the pregnancy.

More information

For more about pregnancy and cancer, visit the American Society of
Clinical Oncology.

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