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A Linked Cancer-Birth Registry Analysis

Eric J. Chow, MD, MPH; Aruna Kamineni, MS; Janet R. Daling, PhD; Alison Fraser, MSPH; Charles L. Wiggins, PhD; Geraldine P. Mineau, PhD; Merlin R. Hamre, MD; Richard K. Severson, PhD; Carolyn Drews-Botsch, PhD; Beth A. Mueller, DrPH

Arch Pediatr Adolesc Med. 2009;163(10):887-894.

Objective  To compare the risk of reproductive and infant outcomes between male childhood cancer survivors and a population-based comparison group.

Design  Retrospective cohort study.

Setting  Four US regions.

Participants  Cancer registries identified males younger than 20 years diagnosed with cancer from 1973 to 2000. Linked birth certificates identified first subsequent live offspring (N = 470). Comparison subjects were identified from remaining birth certificates, frequency-matched on year and age at fatherhood, and race/ethnicity (N = 4150).

Main Exposure  Cancer diagnosis before age 20 years.

Outcome Measures  Pregnancy and infant outcomes identified from birth certificates.

Results  Compared with infants born to unaffected males, offspring of cancer survivors had a borderline risk of having a birth weight less than 2500 g (relative risk, 1.43 [95% confidence interval, 0.99-2.05]) that was associated most strongly with younger age at cancer diagnosis and exposure to any chemotherapy (1.96 [1.22-3.17]) or radiotherapy (1.95 [1.14-3.35]). However, they were not at risk of being born prematurely, being small for gestational age, having malformations, or having an altered male to female ratio. Overall, female partners of male survivors were not more likely to have maternal complications recorded on birth records vs the comparison group. However, preeclampsia was associated with some cancers, especially central nervous system tumors (relative risk, 3.36 [95% confidence interval, 1.63-6.90]).

Conclusions  Most pregnancies resulting in live births among partners of male childhood cancer survivors were not at significantly greater risk of complications vs comparison subjects. However, there remains the possibility that prior cancer therapy may affect male germ cells with some effects on progeny and on female partners.

Author Affiliations: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington (Drs Chow, Daling, and Mueller and Ms Kamineni); Department of Epidemiology, University of Washington, Seattle (Ms Kamineni and Drs Daling and Mueller); Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City (Ms Fraser and Dr Mineau); New Mexico Tumor Registry, Epidemiology and Cancer Control Program, University of New Mexico, Albuquerque (Dr Wiggins); Children's Hospital at Providence, Anchorage, Alaska (Dr Hamre); Departments of Family Medicine and Public Health Sciences, Population Studies and Prevention Program, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan (Dr Severson); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia (Dr Drews-Botsch).

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Pregnancy Outcomes in Female Childhood and Adolescent Cancer Survivors: A Linked Cancer-Birth Registry Analysis
Beth A. Mueller, Eric J. Chow, Aruna Kamineni, Janet R. Daling, Alison Fraser, Charles L. Wiggins, Geraldine P. Mineau, Merlin R. Hamre, Richard K. Severson, and Carolyn Drews-Botsch
Arch Pediatr Adolesc Med. 2009;163(10):879-886.
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