Psychological and neurocognitive outcomes in children born after maternal cancer during pregnancy

The diagnosis of maternal cancer during pregnancy, occurring in 1 in 1,000–2,000 pregnancies, poses complex medical and psychosocial challenges. While early childhood outcomes are generally reassuring, emerging evidence indicates potential long-term effects of prenatal cancer exposure and its treatment. This thesis shifts the focus from short-term maternal and neonatal outcomes to long-term psychosocial, cognitive, and somatic consequences for both children and parents.
Within the nationally centralized Dutch follow-up program of the International Network on Cancer, Infertility and Pregnancy (INCIP), affected families were systematically monitored from infancy through adolescence. Studies included in this thesis highlight vulnerable subgroups and emphasize the need for extended multidisciplinary surveillance.
Prospective evaluations revealed heightened psychological distress and varied coping strategies in pregnant cancer patients and their partners, as well as the profound impact of maternal death on perinatal outcomes. Early parental posttraumatic stress was associated with impaired mother–child bonding and infant sensory sensitivity.
Long-term follow-up of exposed children demonstrated largely normal cognitive, behavioral, cardiac, and pubertal outcomes up to adolescence. However, prematurity, early maternal loss, and lower maternal education consistently predicted poorer outcomes and increased need for support. Specific risks were identified, including delayed neuromotor development in infancy and delayed-onset hearing loss after prenatal platinum exposure. Children exposed to maternal hematological malignancies generally developed within normal ranges, though emotional support remained important.
Taken together, these findings underscore the importance of structured, long-term monitoring and targeted psychosocial support for families facing cancer in pregnancy, with particular attention to high-risk subgroups.