Child development after maternal cancer diagnosis and treatment during pregnancy

Data on the impact of prenatal exposure to maternal malignancy and its treatment on the child’s general health, cognitive, cardiac, behavioral and neurological development are scarce. To address the short- and long-term effects, children exposed to antenatal cancer and cancer treatment are followed in an international, multicenter, longitudinal study by the International Network on Cancer, Infertility and Pregnancy (INCIP). The focus of the research presented is to address the effects of prenatal exposure to maternal malignancy and its treatment, with a major focus on the impact upon neurocognitive development.
Results from this research showed that antenatal chemotherapy is possible and safe after the first trimester. When chemotherapy was administered from the second trimester onwards, the risk of birth defects were similar to the expected rates in the general population. To address the long-term effects of antenatal cancer and cancer treatment, children were prospectively examined through a general neurologic and physical examination, neuropsychological examination and electrocardiogram and echocardiographic assessment at regular time points. This thesis evaluated the largest cohort of children aged six prenatally exposed to maternal cancer, the associated stress, diagnostic imaging and treatments. In general the results of the follow-up studies were reassuring. However, subtle differences with regard to verbal intelligence, visuospatial long-term memory, diastolic blood pressure, auditory function and emotion regulation emphasize the need for long-term follow up and psychosocial support in these children.