Blood cancer during pregnancy increases severe maternal morbidity 22-fold
Click Here to Manage Email Alerts
Key takeaways:
- A blood cancer diagnosis during blood cancer increased risk for severe maternal morbidity 22-fold.
- Blood cancer during pregnancy also increased risk for preterm berth.
Women diagnosed with a hematologic malignancy during pregnancy had a 22-fold higher rate of severe maternal morbidity than those who did not have blood cancer, according to study results.
Additional results showed no difference in 5-year OS between women diagnosed with a hematologic malignancy during pregnancy and those diagnosed in the year after pregnancy.
“Our findings substantially contribute to the understanding of pregnancy-associated [hematologic] malignancy, serving as a valuable resource for health-care providers,” Pierre Pinson, chair of data-centric design engineering at Imperial College London, and colleagues wrote.
Hematologic malignancy during pregnancy is rare; consequently, limited data are available to guide treatment.
Pinson and colleagues conducted a nationwide observational cohort study to assess incidence of pregnancy-associated hematologic malignancies. Investigators also evaluated OS, as well as maternal morbidity and mortality.
They used the French National Healthcare Data System — which includes all pregnancies in France that ended in 2012 through 2022 — to identify 5.9 million women with a combined 9.9 million pregnancies.
Researchers excluded women who terminated a pregnancy or experienced a miscarriage managed on an outpatient basis, as well as women with an already documented history of hematologic malignancy prior to pregnancy.
Researchers identified 1,366 pregnancy-associated hematologic malignancies; of these, 413 (4.13 per 100,000 pregnancies) occurred during pregnancy and 953 (9.53 per 100,000 pregnancies) occurred during the 12 months after pregnancy.
Severe maternal morbidity occurred more frequently among women who developed hematologic malignancy during pregnancy (86 of 328 completed pregnancies = 26.2%) than the general population (120,335 of 7,945,909 completed pregnancies = 1.5%; IPW-adjusted OR = 22.71; 95% CI, 17.7-29.1).
Women diagnosed with hematologic malignancy during pregnancy also had a higher risk than the reference group for birth at less than 32 weeks of pregnancy (9.8% vs. 1.2%; inverse probability weighting-adjusted OR = 11.9; 95% CI, 7.91-17.91) and birth between 32 and 36 weeks of pregnancy (35.4% vs. 5.4%; inverse probability weighting-adjusted OR = 11.76; 95% CI, 9.34-14.81).
Data showed no significant difference in 5-year OS between women diagnosed with hematologic malignancy during pregnancy or in the 12 months following pregnancy (inverse probability weighting-adjusted OR = 0.91; 95% CI, 0.62-1.34). The lack of statistically significant difference persisted when researchers limited their analysis to Hodgkin lymphoma (OR = 0.56; 95% CI, 0.07-4.53), aggressive B-cell non-Hodgkin lymphoma (OR = 0.52; 95% CI, 0.12-2.38) and acute leukemia alone (0.84; 95% CI, 0.5-1.41).
Researchers acknowledged study limitations, including being unable to capture miscarriages or pregnancy terminations that occurred without hospital involvement. They also noted the potential underreporting of specific hematologic malignancies due to patients’ disease state not requiring hospitalization.
“This information aids in treatment planning and supports women and family education,” Pinson and colleagues wrote. “However, challenges remain, and many uncertainties need addressing to improve care for women with pregnancy associated hematological malignancies.”
Collapse
Click Here to Manage Email Alerts