Cancer in Pregnancy. [email protected] 416 813 7887 www.motherisk.org 416 813 6780 press 9. Disclosure. Irena Nulman holds the Canadian Breast Cancer Foundation (CBCF) Grant. Reproduction Today. Women delay childbearing (older age at conception) High-risk pregnancies
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Irena Nulman holds the
Canadian Breast Cancer Foundation (CBCF) Grant
1st Trimester 2nd Trimester 3rd Trimester
1st Trimester 2nd Trimester 3rd Trimester Postnatal
Structural and/or functional deficits for which medical or surgical intervention is necessary or a defect that can impair the child’s future lifestyle
The baseline risk for general population is
1 – 3%, 5%, 7%
Morphologic traits of no serious medical or cosmetic consequence, but might signify a major malformation complex
Even small interference with the process of CNS development may have a profound impact across the life span of an individual
Lewis Wolpet, 1938
edge, dose may only be 4-20 cGy
Diagnostic Procedures & Fetal Risk which is truly the most important time in your life”
Estimated fetal ionizing radiation dose from common diagnostic procedures
for all cancers
small, non- significant excess risk for all cancers and leukemia, but
increased risk of lymphoma OR 5.14 (95% CI 1.27-20.78)
(Cardonic, Lancet Oncol 2004)
(Cardonick , Am J Clin Oncol 2010)
Van Calsteren, J Clin Oncol 2010
Alexander et al, J Clin Oncol 2003
Nulman et al. (2001)
Aviles and Neri (2001)
Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study
Frédéric Amant, Lancet, 2012
Pregnancy outcome and child neurodevelopment following in utero exposure to maternal cancer.
Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto
The Cohort utero exposure to maternal cancer.
The cohort was recruited from the prospectively collected Motherisk database and other Cancer Centers in Ontario.
Results utero exposure to maternal cancer.
Children’s Cognitive Outcome utero exposure to maternal cancer. (mean + SD)
Decrease in blood drug concentration
Higher drug doses may be needed
OR for cranial-neural-crest defects = 8.36
(Hansen et al., Lancet 2000)
Associated with lower mental and motor scores in
8 months old children
(Huizink et al., Journal of Child Psychology and Psychiatry, 2003)