Many women who discover they have cancer while pregnant risk their own health by postponing treatment. But an international collaborative study carried out in Belgium, the Netherlands and the Czech Republic, has shown that, while babies born to women who undergo cytotoxic treatment during pregnancy tend to be born prematurely and are small for gestational age, most achieve a good outcome and the incidence of congenital malformations is comparable to the general population.

The analysis, reported at the 16th International Meeting of the European Society of Gynaecological Oncology (ESGO) in Belgrade, Serbia, 11-14 October 2009, followed up 215 pregnancies in women diagnosed with invasive cancer between 1998 and 2008. Cancer treatment was started during pregnancy in 57% of cases, and it was delayed until after the birth in 27% of pregnancies. The remainder ended in spontaneous miscarriage or were terminated. Delivery was induced in 72% of pregnancies and 54% of children were born preterm.

Babies exposed to cytotoxic treatment in the womb were more likely to be born prematurely (12%, p=0.012), and to be small for gestational age children (24%, p=0.001). However, the incidence of congenital malformations was comparable to the general population.

Dr Kristel Van Kalsteren, from the Katholieke Universiteit Leuven, Leuven, Belgium, concluded that pregnancies complicated by maternal cancer have an overall satisfactory outcome, though the prevention of iatrogenic prematurity deserves attention. She recommended that such women who are diagnosed with cancer while pregnant should be treated in a multidisciplinary setting with access to a maternal and neonatal intensive care unit.