ADIPS SOMANZ Combined Oral Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Maternal and infant outcomes for childhood cancer survivors: a NSW population-based record linkage study (128468)

Heather Baldwin 1 2 , Sarah Pont 1 2 , Joan Rickard-Bell 3 , Antoinette Anazodo 4 5 , Rachael Rodgers 3 4 , Antonia W Shand 1 2 3 , Natasha Nassar 1 2 6
  1. Leeder Centre for Health Policy, Economics, and Data, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  2. Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  3. Royal Hospital for Women, Randwick, Sydney, New South Wales, Australia
  4. University of New South Wales, Sydney, New South Wales, Australia
  5. Sydney Children's Hospital, Sydney, New South Wales, Australia
  6. Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia

Background: Childhood cancer survivors are at increased risk of adverse long-term health outcomes, including impacts on pregnancy and birth. However, there is little evidence about childhood cancer and its treatment on subsequent birth outcomes. We aimed to examine maternal and infant birth outcomes for female survivors of childhood cancer.

Methods: This population-based record-linkage study included women who gave birth in New South Wales (NSW) between 2001–2021 with a history of childhood cancer matched to sibling and population controls. Data from NSW Cancer Registry were linked to births and hospital admissions. Associations between childhood cancer and maternal and infant outcomes were examined using modified Poisson regression models.

Results: Among 1,232 women (1,928 births), 227 (384 births) had previous childhood cancer with 92 (130 births) siblings and 913 (1,414 births) matched population controls. History of childhood cancer was not associated with most adverse maternal outcomes, including diabetes and hypertensive disorders, mode and onset of birth, post-partum haemorrhage and readmission. No association was found for infant outcomes of SGA, LGA, low birthweight or low Apgar score. Compared to population-controls, women with childhood cancer had higher risk of severe maternal morbidity (RR 1.92, 95%CI 1.09 ̶ 3.38), preterm birth (RR 1.51, 95%CI 1.03-2.20), and neonatal resuscitation (RR 1.39, 95%CI 1.11-1.73), but these outcomes were similar to sibling controls (RR 1.05, 95%CI 0.56-1.98 and RR 1.36, 95%CI 0.89-2.06).

Conclusions: Childhood cancer survivors had similar birth outcomes to sibling and population controls. These findings may be used to inform women with a history of childhood cancer.