One of the main concerns of treating a pregnant patient is whether or not the development of the brain of the foetus will be affected, both during and post pregnancy.
Dr Fumagalli addresses if treatment solely effects the development of the baby or if environmental factors also play a part.
The Cancer in Pregnancy meeting 2012 is endorsed by ESGO
Cancer and Pregnancy 2012
Brain development in foetus during cancer treatment
Dr Monica Fumagalli – Fondazione IRCCS Ca’ Granada Ospedale Maggiore Policlinico, Milan, Italy
We know that the brain of the newborn and the brain of the foetus, the so-called developing brain is extremely vulnerable to external insults so we were really interested in looking at these babies and trying to understand if the cancer treatment in pregnancy may have some influence on their later neurodevelopmental outcomes. So now we are planning to follow up these babies to see what happens to them.
Data from literature are very encouraging, saying that these babies really do very good and according to our experience most of these babies were quite healthy at birth and they do very well. But we know that the family and the social environment is very peculiar and this can influence their long-term outcomes.
How do you distinguish between natural and environmental effects?
Yes, I think one of the main questions still to answer is does the cancer treatment have any effect on their development or is their development influenced by the social environment and the family and the maternal status and this is one main issue.
Are there any preliminary results?
We have results on the early neonatal outcomes, most of these babies do quite well but they have a gestational age at birth which is likely younger compared to the normal population. They are usually born in what we call the late pre-term infants, which means that the gestational age is about 35 weeks. So actually they are a bit pre-term babies; they are pre-term babies and they may have some morbidities, early morbidities, in the few days after birth which are related to prematurity itself. But the main question is to understand if these babies, even if they are born just a few weeks before term, perform well when they are four or six or ten years old. This is quite difficult to understand or to investigate because we have different factors – we have the prematurity itself and we have the cancer treatment during pregnancy and we also have the social and family environmental factors also during childhood. We have preliminary data from other countries which are quite encouraging, saying that they are performing quite well. We are planning to have a prospective study in order to better analyse and better investigate the neurodevelopmental outcome of these babies.