Researchers who conducted a nationwide cohort study of children in Denmark concluded that in utero exposure to cancer with or without chemotherapy was not associated with adverse health outcomes. The results of this study were published in the Journal of Clinical Oncology.

The researchers had an aim of determining whether maternal cancer or its treatment had a negative impact on the liveborn children of mothers who had cancer during pregnancy.

The study included all children born alive in Denmark from January 1978 through December 2018 who were categorized based on in utero exposure to maternal cancer. Children in the cancer-exposed group were considered exposed to maternal cancer in utero if a maternal cancer diagnosis occurred during pregnancy. Children in the cancer-unexposed group were born to mothers who were not diagnosed with cancer either during pregnancy or before it. A subgroup analysis examined in utero chemotherapy exposure in persons born after 2002. Overall mortality, somatic diagnoses, and psychiatric diagnoses were the main study outcomes.

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A total of 2,526,163 liveborn children were included in the analysis. Of these, 690 (0.03%) had in utero exposure to maternal cancer. Median follow-up durations were 14.4 years for the cancer-exposed group and 19.7 years for the cancer-unexposed group. The median birthweight in the cancer-exposed group was 3250 g (IQR, 2800-3700), compared with 3490 g (IQR, 3100-3820) in the cancer-unexposed group.

In an adjusted analysis, the cancer-exposed group did not demonstrate a greater overall mortality than was seen with the cancer-unexposed group (adjusted hazard ratio [HR], 0.8; 95% CI, 0.4-1.5).

Congenital malformations also were not associated with a greater risk in the cancer-exposed group, compared with the cancer-unexposed group (adjusted HR, 1.0; 95% CI, 0.8-1.2). Psychiatric diseases overall also did not show a greater risk in the cancer-exposed group (HR, 1.0; 95% CI, 0.8-1.3). Associations also were not found for multiple somatic conditions between cancer-exposed and -unexposed groups. A higher risk of endocrine diseases was seen in the cancer-exposed group (adjusted HR, 1.2; 95% CI, 1.0-1.6), but the researchers noted that this was based on 12 events in the cancer-exposed group.

In the subgroup analysis regarding in utero exposure to chemotherapy, 1,053,109 children were included. Among these, 378 children (0.03%) had been exposed in utero to maternal cancer. Of these children, 42 (12.5%) experienced chemotherapy exposure in utero. Chemotherapy exposure occurred in the second trimester in 73.8% of cases and in the third trimester in 26.2% of cases. Chemotherapy exposure in utero did not appear to be associated with preselected somatic diseases or congenital malformations, compared with a lack of such exposure.

“We found no increase in overall somatic or psychiatric disease burden, nor mortality in these children,” the researchers concluded in their report. “Exposure to chemotherapy in utero among children born within the past 2 decades could not be linked with any adverse health consequences,” they continued.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Greiber IK, Viuff JK, Storgaard L, et al. Long-term morbidity and mortality in children after in utero exposure to maternal cancer. J Clin Oncol. Published online July 7, 2022. doi:10.1200/JCO.22.00599