PMID- 18779621
OWN - NLM
STAT- MEDLINE
DCOM- 20080922
LR  - 20211020
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 26
IP  - 26
DP  - 2008 Sep 10
TI  - Spontaneous abortion in a Danish population-based cohort of childhood cancer 
      survivors.
PG  - 4340-6
LID - 10.1200/JCO.2007.15.2884 [doi]
AB  - PURPOSE: Radiation induces germ-cell mutations in experimental animals that 
      result in adverse pregnancy outcomes, as does uterine damage caused by high-dose 
      radiotherapy. We assessed the risks for spontaneous abortion and stillbirths 
      among cancer survivors who received radiotherapy and subsequently became 
      pregnant. PATIENTS AND METHODS: We identified 1,688 female survivors of childhood 
      cancer in the Danish Cancer Registry. Radiation doses to the ovary and uterus 
      were characterized as high to low. The pregnancy outcomes of survivors, 2,737 
      sisters, and 16,700 comparison women in the population were identified from 
      nationwide registries. The proportions of pregnancies among survivors that 
      resulted in a livebirth, stillbirth, or abortion were compared with the 
      equivalent proportions among the two comparison groups, and proportion ratios 
      (PRs) were computed with sisters as referent. RESULTS: More than 34,000 
      pregnancies were evaluated, 1,479 of which were among cancer survivors. No 
      significant differences were seen between survivors and comparison women in the 
      proportions of livebirths, stillbirths, or all types of abortions combined. 
      Survivors, however, had a 23% excess risk for spontaneous abortion (PR, 1.23; 95% 
      CI, 1.0 to 1.5), related primarily to prior radiation treatments (PR, 1.58; 95% 
      CI, 1.2 to 2.2) and especially high-dose radiotherapy to the ovaries and uterus 
      (PR, 2.8; 95% CI, 1.7 to 4.7). CONCLUSION: The pregnancy outcomes of survivors 
      were similar to those of comparison women. A slight excess risk for spontaneous 
      abortion may have resulted from uterine damage after high-dose pelvic 
      radiotherapy, consistent with previous studies, although radiation-induced 
      germinal mutations or decreased hypothalamic-pituitary-ovarian function could not 
      be ruled out.
FAU - Winther, Jeanette F
AU  - Winther JF
AD  - Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 
      DK-2100 Copenhagen, Denmark; jeanette@cancer.dk.
FAU - Boice, John D Jr
AU  - Boice JD Jr
FAU - Svendsen, Anne Louise
AU  - Svendsen AL
FAU - Frederiksen, Kirsten
AU  - Frederiksen K
FAU - Stovall, Marilyn
AU  - Stovall M
FAU - Olsen, Jorgen H
AU  - Olsen JH
LA  - eng
GR  - R01 CA104666/CA/NCI NIH HHS/United States
GR  - R01 CA104666-04/CA/NCI NIH HHS/United States
GR  - CA104666/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
EIN - J Clin Oncol. 2008 Nov 20;26(33):5493
MH  - Abortion, Spontaneous/*epidemiology
MH  - Cohort Studies
MH  - Denmark/epidemiology
MH  - Female
MH  - Humans
MH  - Neoplasms/*radiotherapy
MH  - Neoplasms, Radiation-Induced/*epidemiology
MH  - Ovary/radiation effects
MH  - Pelvis/radiation effects
MH  - Pregnancy
MH  - Pregnancy Outcome
MH  - Survivors
MH  - Uterus/radiation effects
PMC - PMC2653117
EDAT- 2008/09/10 09:00
MHDA- 2008/09/23 09:00
PMCR- 2009/09/10
CRDT- 2008/09/10 09:00
PHST- 2008/09/10 09:00 [pubmed]
PHST- 2008/09/23 09:00 [medline]
PHST- 2008/09/10 09:00 [entrez]
PHST- 2009/09/10 00:00 [pmc-release]
AID - 26/26/4340 [pii]
AID - 52884 [pii]
AID - 10.1200/JCO.2007.15.2884 [doi]
PST - ppublish
SO  - J Clin Oncol. 2008 Sep 10;26(26):4340-6. doi: 10.1200/JCO.2007.15.2884.