Elyce H. Cardonick, MD; Marcy B. Gringlas, PhD; Krystal Hunter, MBA; Jay Greenspan, MD<\/p>\n
OBJECTIVE: Cancer is diagnosed in approximately 1 per 1000 pregnant women. Lifesaving cancer therapy given to the mother during\u00a0pregnancy appears in conflict with the interest of the developing fetus.\u00a0Often, termination of pregnancy is suggested but has not been proven\u00a0in any type of cancer to improve maternal prognosis, while very few\u00a0studies have documented the long-term effects of in utero chemotherapy exposure on child outcome. To counsel patients about the risk\u00a0of continuing a pregnancy while undergoing cancer treatment, we\u00a0performed developmental testing to provide more detailed follow-up\u00a0on children exposed in utero to chemotherapy.<\/p>\n
STUDY DESIGN: Mother-infant pairs, enrolled in the Cancer and\u00a0Pregnancy Registry, were offered developmental testing for children\u00a0who were 18 months of age. Based on age, the Bayley Scales of\u00a0Infant DevelopmenteThird Edition, the Wechsler Preschool and Primary Scale of Intelligence-Revised, the Wechsler Intelligence Scale for\u00a0Children, Third Edition, or the Wechsler Individual Achievement Test\u00a0was administered. All parents or primary caregivers completed the\u00a0Child Behavior Checklist, a parent questionnaire to assess behavior\u00a0and emotional issues. Results of children exposed to chemotherapy\u00a0before delivery were compared with children whose mothers were also\u00a0diagnosed with cancer during pregnancy but did not receive chemotherapy before delivery.<\/p>\n
RESULTS: No significant differences were noted in cognitive skills,\u00a0academic achievement, or behavioral competence between the\u00a0chemotherapy-exposed group and the unexposed children. Of children, 95% scored within normal limits on cognitive assessments; 71%\u00a0and 79% of children demonstrated at or above age equivalency in\u00a0mathematics and reading scores, respectively; and 79% of children\u00a0scored within normal limits on measures of behavior. Older children\u00a0had significantly higher rates of internalizing behavior problems.<\/p>\n
CONCLUSION: We could not demonstrate a significant difference in\u00a0cognitive ability, school performance, or behavioral competence for\u00a0children exposed to chemotherapy in utero compared with nonexposed controls. The majority of these children scored within normal\u00a0limits on all developmental measures. Premature birth was more\u00a0prevalent in the chemotherapy-exposed group yet did not predict\u00a0developmental outcome. Older children in the sample demonstrated\u00a0higher rates of internalizing behavior problems.<\/p>\n
Cite this article as: Cardonick EH, Gringlas MB, Hunter K, et al. Development of children born to mothers with cancer during pregnancy: comparing in utero chemotherapy-exposed children with nonexposed controls. Am J Obstet Gynecol 2014;212:x.ex-x.ex.<\/p>\n
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