Background:With advances in cancer diagnosis and therapy, survival after childhood and young-adult cancers has improved markedly. As survivorship extends, understanding long-term health sequelae, including obstetric outcomes, has become increasingly important. However, the reproductive safety of pregnancy following cancer remains insufficiently characterized. This systematic review and meta-analysis aims to provide a comprehensive evaluation of obstetric outcomes following pregnancy in survivors of childhood and young-adult cancers.Methods:We conducted a systematic review and meta-analysis (PROSPERO: CRD42024573707) of PubMed, Embase, and Cochrane databases to identify controlled studies assessing obstetric complications among female cancer survivors, published between 1 January 2000 and 31 June 2024. Random effects meta-analyses were used to estimate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity, subgroup analyses, and meta-regression were performed to identify sources of variation.Results:Of 6032 records screened, 16 studies involving 89,123 survivors and 21,569,191 controls were included. Cancer survivorship was associated with higher risks of preeclampsia (RR 1.37, 95% CI 1.17–1.62), gestational diabetes (RR 1.29, 95% CI 1.05–1.59), and miscarriage (RR 1.16, 95% CI 1.01–1.35), but not with anemia in pregnancy (RR 1.16, 95% CI 0.98–1.39) or hypertensive disorders (RR 1.21, 95% CI 0.99–1.49). Cancer type emerged as a potential prognostic factor for preeclampsia.Conclusions:Female cancer survivors are at significantly increased risk of major obstetric complications, underscoring the need for anticipatory preconception counselling and enhanced antenatal surveillance. Future research should delineate cancer- and treatment-specific risks to inform precision reproductive care in this growing survivorship population.
背景：随着癌症诊断与治疗技术的进步，儿童及青少年癌症患者的生存率显著提高。随着生存期的延长，了解包括产科结局在内的长期健康后遗症变得日益重要。然而，癌症后妊娠的生殖安全性仍未得到充分阐明。本系统综述与荟萃分析旨在全面评估儿童及青少年癌症幸存者妊娠后的产科结局。 方法：我们对PubMed、Embase和Cochrane数据库进行了系统综述与荟萃分析（PROSPERO注册号：CRD42024573707），检索了2000年1月1日至2024年6月31日期间发表的评估女性癌症幸存者产科并发症的对照研究。采用随机效应模型进行荟萃分析，计算合并风险比及其95%置信区间。通过异质性检验、亚组分析和荟萃回归分析识别变异来源。 结果：在筛选的6032条记录中，共纳入16项研究，涉及89,123名幸存者和21,569,191名对照者。癌症幸存者与更高的先兆子痫风险、妊娠期糖尿病风险以及流产风险相关，但与妊娠期贫血或高血压疾病无显著关联。癌症类型被确定为先兆子痫的潜在预后因素。 结论：女性癌症幸存者发生主要产科并发症的风险显著增加，这凸显了进行孕前咨询和加强产前监测的必要性。未来研究应明确不同癌症类型及治疗方式的具体风险，以期为这一不断增长的幸存者群体提供精准的生殖健康管理策略。
肿瘤(癌症)患者之家