Pregnancy outcome in long-term survivors of childhood cancer.

BACKGROUND: By the year 2010, 1/250 young adults will be long-term survivors of childhood cancer. One of the major concerns is whether they will be able to have healthy children.

PROCEDURE: The literature was reviewed to determine 1) the extent of intrapartum and perinatal complications experienced by survivors or their spouses and 2) the risk of congenital malformations or cancer in their children.

RESULTS AND CONCLUSIONS: Series have reported on pregnancy complications among approximately 400 female survivors and 300 partners of male survivors. An increased incidence of spontaneous abortions, low-birth-weight babies, and neonatal deaths has been described for women with Wilms tumor who had received at least 20 Gy abdominal radiation. Hodgkin disease survivors who had received both radiation and chemotherapy (but not either alone) also appear to be at increased risk of spontaneous abortions. Based on several thousand survivor offspring, there is no overall increased risk of either congenital malformations or childhood cancer. Further studies will define the outcome of offspring of cancer survivors treated in the modern era.