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Cao Y, Zhao S, Bexelius TS, Söderling J, Shi M, Roelstraete B, Warner BB, Stephansson O, Ludvigsson JF. Pregnancy and neonatal outcomes among women with early-onset colorectal cancer: a nationwide case-control study. EClinicalMedicine 2023; 59:101963. [PMID: 37125404 PMCID: PMC10139893 DOI: 10.1016/j.eclinm.2023.101963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background Early-onset colorectal cancer has risen worldwide, leaving more women with colorectal cancer at reproductive ages. We aimed to investigate the risk of adverse pregnancy and neonatal outcomes among women with early-onset colorectal cancer. Methods We conducted a nationwide, matched case-control study of maternal/pregnancy outcomes including pre-eclampsia and Cesarean delivery (C-section) as well as neonatal outcomes including preterm birth among 207 births in women with early-onset colorectal cancer (ages 18-49) and 1019 births in women without colorectal cancer in Sweden (1992-2019). Early-onset colorectal cancer cases were identified through the Cancer Register, and outcome data were retrieved through linkage to Medical Birth Register and National Patient Register. Using conditional logistic regression, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Findings Between Jan 1, 1992, and Dec 31, 2019, women with early-onset colorectal cancer who gave birth had increased odds of pre-eclampsia (7.2% vs 3.2%; OR = 2.52, 95%CI = 1.25-5.08), any C-section (24.6% vs 19.4%; OR = 1.43, 95%CI = 1.00-2.06), particularly emergency C-section (17.4% vs 10.5%; OR = 1.79, 95%CI = 1.17-2.75), after adjustment for maternal education level, country of birth, body mass index and smoking in early pregnancy, and comorbidities. Maternal history of early-onset colorectal cancer was also associated with offspring preterm birth (12.1% vs 5.2%; OR = 2.31, 95%CI = 1.34-3.99), delineated as spontaneous (OR = 1.06, 95%CI = 0.47-2.39) or medically-indicated preterm birth (OR = 4.48, 95%CI = 2.05-9.79). There was no increased risk of congenital malformation or small for gestational age birth. Interpretation In this population-based study, maternal history of early-onset colorectal cancer was associated with risk of both adverse pregnancy (pre-eclampsia, C-section) and neonatal outcomes (preterm birth). Funding US National Institutes of Health, Swedish Society of Medicine, Swedish Cancer Foundation.
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Affiliation(s)
- Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephanie Zhao
- School of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Tomas S. Bexelius
- Department of Women's and Children's Health, Childhood Cancer Research Unit and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Paediatric Oncology, Astrid Lindgren Children Hospital, Stockholm, Sweden
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mengyao Shi
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Bjorn Roelstraete
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Barbara B. Warner
- Division of Newborn Medicine, Department of Pediatrics, Washington University in St Louis, St Louis, MO, USA
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Division of Women's Health, Department of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
| | - Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA
- Corresponding author. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-17177, Stockholm, Sweden.
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Bertrand A, Aho S, Rousset-Jablonski C, Cessot M, Christophe V, Marec-Bérard P, Ray-Coquard I. Dedicated Program for Adolescent and Young Adults With Cancer: A Better Way to Inform About Sexual and Fertility Issues. JCO Oncol Pract 2021; 17:642. [PMID: 34436935 DOI: 10.1200/op.21.00452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Amandine Bertrand
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Simon Aho
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Christine Rousset-Jablonski
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Marion Cessot
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Véronique Christophe
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Perrine Marec-Bérard
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Isabelle Ray-Coquard
- Amandine Bertrand, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France, RESHAPE U1290, Lyon, France, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Simon Aho, MD, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Christine Rousset-Jablonski, PhD, RESHAPE U1290, Lyon, France, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Marion Cessot, MD, Department of Surgical Oncology, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Véronique Christophe, PhD, Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France; Perrine Marec-Bérard, MD, Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; and Isabelle Ray-Coquard, PhD, RESHAPE U1290, Lyon, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France
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