■早发性结直肠癌在全球范围内上升,使更多的女性在生育年龄患有结直肠癌。我们旨在调查早发性结直肠癌妇女不良妊娠和新生儿结局的风险。
■我们在全国范围内进行了一次,在瑞典(1992-2019年),早发性结直肠癌妇女(18-49岁)的207例分娩和无结直肠癌妇女的1019例分娩中,孕产妇/妊娠结局包括先兆子痫和剖腹产(剖腹产)以及新生儿结局包括早产的配对病例对照研究.早发性结直肠癌病例是通过癌症登记处确定的,通过与医学出生登记和国家患者登记的链接检索结果数据。使用条件逻辑回归,我们估计了多变量校正比值比(ORs)和95%置信区间(CIs).
■在1992年1月1日至2019年12月31日之间,分娩的早发型结直肠癌妇女患先兆子痫的几率增加(7.2%vs3.2%;OR=2.52,95CI=1.25-5.08),任何剖腹产(24.6%对19.4%;OR=1.43,95CI=1.00-2.06),特别是紧急剖腹产(17.4%vs10.5%;OR=1.79,95CI=1.17-2.75),在调整了母亲的教育水平后,出生国,怀孕早期的体重指数和吸烟,和合并症。早发性结直肠癌的母体病史也与后代早产相关(12.1%vs5.2%;OR=2.31,95CI=1.34-3.99),分为自发性早产(OR=1.06,95CI=0.47-2.39)或医学指示早产(OR=4.48,95CI=2.05-9.79).先天性畸形或小于胎龄出生的风险没有增加。
■在这项基于人群的研究中,早发型结直肠癌的母体病史与两种不良妊娠的风险相关(先兆子痫,剖腹产)和新生儿结局(早产)。
■美国国立卫生研究院,瑞典医学学会,瑞典癌症基金会。
UNASSIGNED: Early-onset colorectal cancer has risen worldwide, leaving more women with colorectal cancer at reproductive ages. We aimed to investigate the risk of adverse pregnancy and neonatal outcomes among women with early-onset colorectal cancer.
UNASSIGNED: We conducted a nationwide, matched
case-control study of maternal/pregnancy outcomes including pre-eclampsia and Cesarean delivery (C-section) as well as neonatal outcomes including preterm birth among 207 births in women with early-onset colorectal cancer (ages 18-49) and 1019 births in women without colorectal cancer in Sweden (1992-2019). Early-onset colorectal cancer cases were identified through the Cancer Register, and outcome data were retrieved through linkage to Medical Birth Register and National Patient Register. Using conditional logistic regression, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
UNASSIGNED: Between Jan 1, 1992, and Dec 31, 2019, women with early-onset colorectal cancer who gave birth had increased odds of pre-eclampsia (7.2% vs 3.2%; OR = 2.52, 95%CI = 1.25-5.08), any C-section (24.6% vs 19.4%; OR = 1.43, 95%CI = 1.00-2.06), particularly emergency C-section (17.4% vs 10.5%; OR = 1.79, 95%CI = 1.17-2.75), after adjustment for maternal education level, country of birth, body mass index and smoking in early pregnancy, and comorbidities. Maternal history of early-onset colorectal cancer was also associated with offspring preterm birth (12.1% vs 5.2%; OR = 2.31, 95%CI = 1.34-3.99), delineated as spontaneous (OR = 1.06, 95%CI = 0.47-2.39) or medically-indicated preterm birth (OR = 4.48, 95%CI = 2.05-9.79). There was no increased risk of congenital malformation or small for gestational age birth.
UNASSIGNED: In this population-based study, maternal history of early-onset colorectal cancer was associated with risk of both adverse pregnancy (pre-eclampsia, C-section) and neonatal outcomes (preterm birth).
UNASSIGNED: US National Institutes of Health, Swedish Society of Medicine, Swedish Cancer Foundation.