Background/Objectives: Breast cancer may negatively affect later pregnancy and childbirth. We aimed to analyze the impact of previous breast cancer on obstetric outcomes in postdiagnosis pregnancies. Methods: Insurance claims data in Southern Germany were used to identify breast cancer (BC) survivors with at least one subsequent delivery after cancer diagnosis between 2010 and 2020. In total, 74 BC survivors were compared to 222 age-matched controls with frequency matching on their age at their postdiagnosis delivery. Results: Endocrine therapy was associated with a significantly lower probability of birth compared to BC survivors without endocrine therapy (HR 0.36; 95% CI 0.18–0.53;p< 0.0001). The risks of preterm birth, low birth weight (LBW), gestational diabetes, hypertensive disorders, and cesarean section were not significantly increased among BC survivors compared to healthy controls. BC survivors were at an increased risk for a small-for-gestational-age (SGA) fetus (OR 3.24; 95% CI 1.17–8.97,p= 0.03). Delivery in less than 2 years after diagnosis increased the risk for SGA (OR 5.73; 95% CI 1.37–24.02,p= 0.03) and LBW (OR 4.57; 95% CI 1.32–15.87,p= 0.02). Conclusions: Our findings are encouraging regarding the risks of preterm delivery, gestational diabetes, hypertensive disorders, and cesarean section to women who consider pregnancy after BC. Delivery in less than 2 years after diagnosis was associated with an increased risk for SGA and LBW.
背景/目的：乳腺癌可能对后续妊娠及分娩产生负面影响。本研究旨在分析既往乳腺癌病史对诊断后妊娠期产科结局的影响。方法：采用德国南部医疗保险理赔数据，识别2010年至2020年间确诊乳腺癌后至少有一次分娩记录的幸存者。共纳入74名乳腺癌幸存者，并按照诊断后分娩时的年龄进行频数匹配，选取222名年龄匹配的对照者。结果：与未接受内分泌治疗的乳腺癌幸存者相比，接受内分泌治疗者的分娩概率显著降低（风险比0.36；95%置信区间0.18–0.53；p<0.0001）。与健康对照组相比，乳腺癌幸存者的早产、低出生体重、妊娠期糖尿病、高血压疾病及剖宫产风险均未显著升高。但乳腺癌幸存者发生小于胎龄儿的风险显著增加（比值比3.24；95%置信区间1.17–8.97，p=0.03）。诊断后不足2年内分娩会显著增加小于胎龄儿（比值比5.73；95%置信区间1.37–24.02，p=0.03）和低出生体重儿（比值比4.57；95%置信区间1.32–15.87，p=0.02）的发生风险。结论：本研究为考虑乳腺癌后妊娠的女性提供了积极信息：其早产、妊娠期糖尿病、高血压疾病及剖宫产风险未见显著升高。但需注意诊断后不足2年内分娩可能增加小于胎龄儿及低出生体重儿的风险。
Adverse Obstetric Outcomes after Breast Cancer Diagnosis: An Observational Database Study in Germany
肿瘤(癌症)患者之家