Birth Outcomes Among Adolescent and Young Adult Cancer Survivors Interview with:

Hazel B. Nichols, PhD, UNC, assistant professor Lineberger Comprehensive Cancer Center member UNC Gillings School of Global Public Health.

Dr. Nichols

Hazel B. Nichols, PhD, UNC
Assistant professor
Lineberger Comprehensive Cancer Center member
UNC Gillings School of Global Public Health. What is the background for this study?

Response: Each year more than 45,000 adolescent and young adult women (AYA, ages 15-39 years) are diagnosed with cancer in the United States. While many of these women may wish to have children in the years following diagnosis, there is currently little information available to address their concerns about the impact of cancer diagnosis and treatment on future pregnancy.

We identified >2,500 women who had a child after their cancer diagnosis using data from the North Carolina Central Cancer registry and statewide birth certificate files. We investigated whether adverse birth outcomes, such as preterm birth and low birth weight, were more common among AYA cancer survivors compared to women without cancer. We also looked at infant Apgar scores, which measure newborn health, and a calculation called small-for-gestational age, which can indicate restricted growth during pregnancy. What are the main findings?

Response: Overall, adolescent and young adult cancer survivors in our study were more likely to deliver preterm and low birth weight infants than women without a cancer diagnosis. For other outcomes, including small for gestational age and low Apgar scores, we saw no differences between the groups. Preterm birth was more common among AYA cancer survivors who were treated with chemotherapy, or for breast, lymphoma, or gynecologic cancers. What should readers take away from your report?

Response: The positive takeaway from our study is that we were able to identify a large number of women who went on to have a child after an AYA cancer diagnosis. We saw an increase in preterm deliveries among women with a cancer history, especially those treated with chemotherapy, even years after cancer diagnosis. Our study gives us important evidence about pregnancy risks after cancer treatment, and suggests that a cancer history may be a risk factor to consider, like smoking status or maternal age, when planning prenatal care. What recommendations do you have for future research as a result of this study?

Response: In our study, we found that treatment with chemotherapy may be a risk factor for preterm birth. Our next steps will be to look more closely at the types of chemotherapy women receive to better understand how cancer treatment affects future pregnancy.

No disclosures. Thank you for your contribution to the community.


Anderson C, Engel SM, Mersereau JE, Black KZ, Wood WA, Anders CK, Nichols HB. Birth Outcomes Among Adolescent and Young Adult Cancer Survivors. JAMA Oncol. Published online March 23, 2017. doi:10.1001/jamaoncol.2017.0029

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 27, 2017 by Marie Benz MD FAAD