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

Journal Article (Journal Article)

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 (Pinteraction = .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.

Full Text

Duke Authors

Cited Authors

  • Gawade, PL; Oeffinger, KC; Sklar, CA; Green, DM; Krull, KR; Chemaitilly, W; Stovall, M; Leisenring, W; Armstrong, GT; Robison, LL; Ness, KK

Published Date

  • January 2015

Published In

Volume / Issue

  • 212 / 1

Start / End Page

  • 47.e1 - 47.10

PubMed ID

  • 25068563

Pubmed Central ID

  • PMC4275351

Electronic International Standard Serial Number (EISSN)

  • 1097-6868

Digital Object Identifier (DOI)

  • 10.1016/j.ajog.2014.07.036


  • eng

Conference Location

  • United States