Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort Journal Article


Authors: Gawade, P. L.; Oeffinger, K. C.; Sklar, C. A.; Green, D. M.; Krull, K. R.; Chemaitilly, W.; Stovall, M.; Leisenring, W.; Armstrong, G. T.; Robison, L. L.; Ness, K. K.
Article Title: Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort
Abstract: Objective To evaluate associations between prepregnancy lifestyle factors, psychologic distress and adverse pregnancy outcomes among female survivors of childhood cancer. Study Design We examined pregnancies of 1192 female participants from the Childhood Cancer Survivor Study. Generalized linear models, adjusted for age at diagnosis, age at pregnancy, parity, and education were used to calculate the odds ratio (OR) and confidence interval (CI) for associations between prepregnancy inactivity, overweight or obese status, smoking status, risky drinking, psychologic distress and pregnancy outcomes. Interactions between lifestyle factors, psychologic distress, type of cancer and cancer treatment were assessed in multivariable models. Results The median age of study participants at the beginning of pregnancy was 28 years (range, 14-45). Among 1858 reported pregnancies, there were 1300 singleton live births (310 were preterm), 21 stillbirths, 397 miscarriages, and 140 medical abortions. Prepregnancy physical inactivity, risky drinking, distress, and depression were not associated with any pregnancy outcomes. Compared with those who had never smoked, survivors with >5 pack-years smoking history had a higher risk for miscarriage among those treated with >2.5 Gray (Gy) uterine radiation (OR, 53.9; 95% CI, 2.2-1326.1) than among those treated with 2.5 Gy uterine radiation (OR, 1.9; 95% CI, 1.2-3.0). There was a significant interaction between smoking and uterine radiation (P;b =.01). Conclusion Although most lifestyle factors and psychologic distress were not predictive of adverse pregnancy outcomes, the risk for miscarriage was significantly increased among survivors exposed to 2.5 Gy uterine radiation who had a history of smoking. © 2015 Elsevier Inc.
Keywords: smoking; pregnancy; childhood cancer survivors; lifestyle; uterine radiation
Journal Title: American Journal of Obstetrics and Gynecology
Volume: 212
Issue: 1
ISSN: 0002-9378
Publisher: Elsevier Inc.  
Date Published: 2015-01-01
Start Page: 47.e1
End Page: 47.e10
Language: English
DOI: 10.1016/j.ajog.2014.07.036
PROVIDER: scopus
PMCID: PMC4275351
PUBMED: 25068563
DOI/URL:
Notes: Export Date: 2 January 2015 -- Source: Scopus
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  1. Charles A Sklar
    322 Sklar
  2. Kevin Oeffinger
    296 Oeffinger