162MO - Long-term development of 12- and 15-year-old offspring after maternal cancer during pregnancy: A prospective multicentre cohort study

Background

Evidence is lacking on the long-term effects of prenatal exposure to maternal cancer and its treatment on adolescent cognitive, behavioural, cardiac and physical health.

Methods

In a multicentre cohort study, children aged 12 and/or 15 years, prenatally exposed to maternal cancer, underwent clinical evaluation, echocardiography, neurocognitive evaluation (intelligence, attention, memory), and parent-reported questionnaires on executive and behavioural functioning. Echocardiographic, neurocognitive, and behavioural results were standardised using normative data. Associations between neurocognitive outcomes and covariates were examined using one-way and multivariable ANOVA. Further analyses examined the need for extra support and the impact of chemotherapy exposure on puberty onset.

Results

Of 166 children, 84 (51%) were assessed only at age 12 years, 25 (15%) only at age 15, and 57 (34%) at both ages. During pregnancy, 122 children (73%) were exposed to chemotherapy, 17 (10%) to surgery alone, 14 (8%) to radiotherapy, one (1%) to trastuzumab, one (1%) to rituximab, and 21 (13%) to no treatment. Cardiac, cognitive, and behavioural outcomes were within normal ranges. Maternal death was negatively associated with visuospatial memory. Preterm-born children and boys scored lower on attention. Prenatal chemotherapy exposure was negatively associated with verbal memory. Physical development and puberty onset were within standard ranges. The need for extra support correlated with lower intelligence and attention scores, higher behavioural and executive functioning problems and prematurity.

Conclusions

No significant disruptions were found in the development of adolescents prenatally exposed to maternal cancer and its treatment. Differences in cognitive outcomes were linked to maternal death and prematurity, although verbal memory was partly associated with chemotherapy exposure. Ongoing monitoring is recommended to understand long-term outcomes into adulthood.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

KWF Kankerbestrijding, Netherlands; Kom op Tegen Kanker (KOTK), Belgium; Cooperatio program, Charles University, Czechia.

Disclosure

All authors have declared no conflicts of interest.