Will chemotherapy during pregnancy affect fetal health?

　　Research shows that during pregnancy cancer Treatment does not cause fetus long-term damage occurs

　　If a pregnant woman is diagnosed with cancer, her doctor, herself, and her family face a difficult choice: The mother's healthy Is it important, or is the health of the fetus more important? It is known that the risk of birth defects increases when chemotherapy drugs are used during the first 12 weeks of pregnancy, when fetal organs are forming. If chemotherapy is delayed, it can cause the cancer to spread. Over the past decade, although doctors have often chosen to wait until the third trimester before using chemotherapy drugs, there are still concerns about damage to the fetus's brain and heart.

　　Now, researchers publishing an article in the journal Lancet Oncology claim they have provided reliable results by following 70 children whose mothers received chemotherapy during pregnancy.

　　The research team retrospectively recruited some children starting in 2005, followed others from birth, and conducted physical and intellectual tests every few years on the children, who ranged in age from 18 months to 18 years.

　　Among these children, except premature birth The thinking and reasoning abilities of other children are no different from those of ordinary children. These premature babies are often born earlier so that their mothers can receive chemotherapy earlier, and their developmental scores are often lower than those of full-term babies (40 weeks gestation). After taking into account factors such as age, gender, country of birth, etc., if these children can Uterus If you stay in Japan for one more month, your IQ will rise by 12 points.

　　A small number of pregnant women with cancer still choose to have an abortion, but researchers say the placenta actually acts like a filter, filtering out those chemotherapy drugs and reducing their impact on the fetus. “There are often mothers who are bald due to chemotherapy. baby But the phenomenon of a head full of hair may indicate that these drugs are not absorbed by the fetus as much as we think. ”

　　female Delaying the age of pregnancy increases the risk of cancer in pregnant women

　　As women tend to have children later in life, more women are being diagnosed with cancer during pregnancy. Works at Johns Hopkins, Baltimore Hospital of breast cancer Lillian Shockney, a department nurse, believes that pregnancy itself does not increase the risk of breast cancer, but many women's choice to postpone pregnancy will increase the risk of cancer in pregnant women. “We know that age is a risk factor for breast cancer, so having a baby after age 30 is associated with a higher risk of developing breast cancer," Shockney said. She is also a surgeon at the Johns Hopkins University School of Medicine, Gynecology , associate professor of oncology and obstetrics. Pregnancy can also delay diagnosis by masking the signs of cancer, but this occurs in only one in 1,000 pregnant women.

　　Experts recommend that pregnant women who need treatment and have cancer receive immediate treatment, rather than letting them go through a long wait before having their children born early through surgery or other methods, because the latter may cause greater harm to the child. “"Our study shows that children exposed to chemotherapy during fetal life are like other children," the authors concluded, "and that uniform chemotherapy selection criteria should be followed for pregnant and non-pregnant women." In practice, cancer patients who are 14 weeks pregnant and above can receive chemotherapy with careful pregnancy care. ”

　　But the authors added that they could not guarantee that the treatment would not have an impact on their children in the years to come, so more follow-up studies are needed to understand whether these children will have impaired fertility as adults or be more susceptible to cancer. They said: "Time will tell what the consequences of fetal exposure to chemotherapy drugs will be, including fertility and the development of secondary tumors, especially when drugs that cause DNA damage are used. ”