Maternal cancer and treatment during pregnancy is an emerging challenge and may affect child development even years after the child was born. However, a recent study published in the Journal of Clinical Oncology reports encouraging results about this matter. In this study, children prenatally exposed to maternal cancer (treatment) showed, on average, a normal cognitive and behavioural development at age 9 years.
Maternal cancer during pregnancy is an emerging challenge and may affect pre- and postnatal child development through both direct treatment effects, or indirectly through environmental and psychosocial effects. In previous studies, foetal exposure to chemotherapy was not associated with increased central nervous system, cardiac or auditory morbidity, nor did it impair the general health and growth of children compared to the general population. However, the question remains whether these children are at risk of developing neurocognitive and general health deficits in later life, when complex cognitive and executive functions are developing. This report describes the cognitive and behavioural outcomes of 9-year-old children prenatally exposed to maternal cancer and its treatment.
In total, 151 children (mean age, 9.3 years) were assessed using a neurocognitive test battery and parent-report behavioural questionnaires. During pregnancy, 109 children (72.2%) were exposed to chemotherapy (only or in combination with other treatment modalities), 18 (11.9%) to surgery only, 16 (10.6%) to radiotherapy and one to trastuzumab. The remaining 16 (10.6%) patients were not exposed to oncologic treatment.
Group outcomes for all intelligence outcomes, verbal and visuospatial memory, attentional function, and behavioural measures were within normal ranges. No difference in Full Scale Intelligence Quotient (FSIQ) was found between girls and boys (p=0.802), treatment types (p=0.776), or cancer stages (p=0.211). Gestational age at birth showed a positive association with FSIQ, with the average FSIQ score increasing by 1.6 points for each week increase in gestational age (p<0.001). In children prenatally exposed to chemotherapy, no associations were found between FSIQ and chemotherapeutic agent, exposure level, or timing during pregnancy.
In conclusion, children prenatally exposed to maternal cancer (treatment) showed, on average, a normal cognitive and behavioural development at 9 years of age. However, these children still require a close follow-up, as maternal cancer during pregnancy is associated with preterm delivery and maternal death, which are risk factors for developmental problems.
Van Assche IA, Huis in ‘t Veld EA, Van Calsteren K, et al. Cognitive and Behavioral Development of 9-Year-Old Children After Maternal Cancer During Pregnancy: A Prospective Multicenter Cohort Study. J Clin Oncol. 2023;8:1527-32.