Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy

Abstract

Background: Data on the long-term effects of prenatal exposure to maternal cancer and its treatment on child development are scarce. Method(s): In a multicentre cohort study, the neurologic and cardiac outcomes of 6- year-old children born to women diagnosed with cancer during pregnancy (study group) were compared to the outcome of children born after an uncomplicated pregnancy (control group) (ClinicalTrials.gov, NCT00330447). Neurodevelopment was assessed by clinical evaluation and neuropsychological testing (including intelligence, attention and memory tests) and by general health and behaviour questionnaires. Cardiac evaluation included electro- and echocardiography. Result(s): In total, 132 study children and 132 controls (mean age 6.2 years) were included. In the study group, 97 children (73.5%) were prenatally exposed to chemotherapy (alone or in combination with other treatments), 14 (10.6%) to radiotherapy (alone or in combination), 1 (0.8%) to trastuzumab, 12 (9.1%) to surgery alone and 16 (12.1%) to no treatment. Although within normal ranges, the mean Verbal IQ score was significantly lower in the study versus control group (98.9 vs 103.0, p=0.001, q<0.001). Also, children in the study group had a significantly lower score for visuospatial long-term memory compared to the control group (3.9 vs 4.5, p=0.005, q=0.043). No significant differences were found in Full Scale IQ, Performance IQ, Processing Speed, memory span, verbal and visuospatial short-term memory, attention and behaviour problems or in cardiac dimensions and left ventricular function. Conclusion(s): Children prenatally exposed to maternal cancer and its treatment may be at risk for lower Verbal IQ and visuospatial long-term memory scores, but other cognitive functions and cardiac outcomes were normal at the age of 6 years.