{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:23:56Z","timestamp":1790900636345,"version":"4.1.0"},"reference-count":48,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"name":"Washington State Obstetrical Association","award":["2016"],"award-info":[{"award-number":["2016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>\n            Objective\u2003Cancer and pregnancy are likely increasing; however, updated estimates are needed to optimally address the unique needs of this patient population. The study aims to estimate the prevalence of cancer and cancer survivorship at delivery, to test the change in odds of cancer and cancer survivorship at delivery over the 10-year period, and to compare medical conditions, serious events, and obstetric complications between pregnancies with and without cancer at delivery.<\/jats:p><jats:p>\n            Study Design\u2003We conducted a retrospective analysis of the National Inpatient Sample (NIS), the largest all-payer inpatient health database in the United States. We identified delivery admissions from 2004 to 2013 with a concurrent diagnosis of cancer using International Classification of Disease, ninth revision (ICD-9) codes. Multivariable logistic regression was used to test the change in prevalence of concurrent cancer, cancer survivorship, and pregnancy and to compare outcomes between deliveries with and without cancer. All analyses were adjusted for NIS-provided population weights and strata.<\/jats:p><jats:p>\n            Results\u2003During the study period, the NIS represented a national estimate of 40,855,208 deliveries. The odds of cancer increased from 3.41\/10,000 deliveries in 2004 to 4.33\/10,000 in 2013. This trend was statistically significant, including after adjustment for maternal age (adjusted odds ratio [aOR]\u2009=\u20091.03 [95% confidence interval (CI): 1.01\u20131.04]). Cancer survivorship at delivery increased significantly (aOR\u2009=\u20091.07 [95% CI: 1.06\u20131.08]). Women with cancer more often experienced one or more of the following: death, ventilation, cardiac arrest, sepsis, or acute respiratory or renal failure during delivery (aOR for composite outcome 10.7 [95% CI: 6.6\u201317.2]), even after adjustment in a multivariable logistic regression model.<\/jats:p><jats:p>\n            Conclusion\u2003The odds of cancer and cancer survivorship at delivery increased from 2004 to 2013, independent of maternal age. Women with cancer were more likely to experience medical or obstetric complications during their delivery compared with women without cancer. These findings highlight the importance of obstetric and oncologic clinical and research collaboration to improve patient care.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1714394","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T23:50:51Z","timestamp":1595375451000},"page":"144-153","source":"Crossref","is-referenced-by-count":32,"title":["Cancer and Pregnancy: National Trends"],"prefix":"10.1055","volume":"39","author":[{"given":"Kimberly K.","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Monsell","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Chandrasekaran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayakrishna K.","family":"Gadi","sequence":"additional","affiliation":[{"name":"Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington"},{"name":"Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington"},{"name":"Division of Medical Oncology, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary S.","family":"Gammill","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Washington, Seattle, Washington"},{"name":"Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1097\/AOG.0b013e3182a057a2","article-title":"Incidence of pregnancy-associated cancer in Denmark, 1977-2006","volume":"122","author":"S Eibye","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"13","key":"ref3","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1111\/j.1471-0528.2012.03475.x","article-title":"Incidence and outcomes of pregnancy-associated cancer in Australia, 1994-2008: a population-based linkage study","volume":"119","author":"Y Y Lee","year":"2012","journal-title":"BJOG"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1067\/S0002-9378(03)00537-4","article-title":"Cancer associated with obstetric delivery: results of linkage with the California cancer registry","volume":"189","author":"L H Smith","year":"2003","journal-title":"Am J Obstet Gynecol"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1067\/mob.2001.114867","article-title":"Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997","volume":"184","author":"L H Smith","year":"2001","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1634\/theoncologist.2002-0279","article-title":"Coexistence of pregnancy and malignancy","volume":"7","author":"N A Pavlidis","year":"2002","journal-title":"Oncologist"},{"key":"ref7","first-page":"857","article-title":"Carcinoma in situ and pregnancy","volume":"24","author":"T J Williams","year":"1964","journal-title":"Obstet Gynecol"},{"issue":"232","key":"ref8","first-page":"1","article-title":"Mean Age of Mothers is on the Rise: United States, 2000-2014","author":"T J Mathews","year":"2016","journal-title":"NCHS Data Brief"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/S1470-2045(04)01466-4","article-title":"Use of chemotherapy during human pregnancy","volume":"5","author":"E Cardonick","year":"2004","journal-title":"Lancet Oncol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0140-6736(11)61814-X","article-title":"Cancer in pregnancy: a challenging conflict of interest","volume":"379","author":"P Morice","year":"2012","journal-title":"Lancet"},{"issue":"S 06","key":"ref11","doi-asserted-by":"crossref","first-page":"vi160","DOI":"10.1093\/annonc\/mdt199","article-title":"Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"24","author":"F A Peccatori","year":"2013","journal-title":"Ann Oncol"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/IGC.0000000000000062","article-title":"Gynecologic cancers in pregnancy: guidelines of a second international consensus meeting","volume":"24","author":"F Amant","year":"2014","journal-title":"Int J Gynecol Cancer"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ajog.2013.12.002","article-title":"Cancer and pregnancy: an overview for obstetricians and gynecologists","volume":"211","author":"R Salani","year":"2014","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.bpobgyn.2015.02.006","article-title":"Management of cancer in pregnancy","volume":"29","author":"F Amant","year":"2015","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"658.e1","DOI":"10.1016\/j.ajog.2014.11.032","article-title":"Development of children born to mothers with cancer during pregnancy: comparing in utero chemotherapy-exposed children with nonexposed controls","volume":"212","author":"E H Cardonick","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1200\/JCO.2015.62.4445","article-title":"Hematologic malignancies in pregnancy: Management guidelines from an international consensus meeting","volume":"34","author":"M Lishner","year":"2016","journal-title":"J Clin Oncol"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5468\/ogs.2016.59.1.1","article-title":"Clinical characteristics and outcome of cancer diagnosed during pregnancy","volume":"59","author":"M H Shim","year":"2016","journal-title":"Obstet Gynecol Sci"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.jare.2016.01.004","article-title":"A mini review on pregnant mothers with cancer: a paradoxical coexistence","volume":"7","author":"S Mitrou","year":"2016","journal-title":"J Adv Res"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S1470-2045(18)30059-7","article-title":"Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients","volume":"19","author":"J de Haan","year":"2018","journal-title":"Lancet Oncol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1002\/ijc.2910340214","article-title":"Pregnancy in association with a newly diagnosed cancer: a population-based epidemiologic assessment","volume":"34","author":"J F Haas","year":"1984","journal-title":"Int J Cancer"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1136\/bmj.311.7020.1607","article-title":"Cancers coinciding with childbearing: delayed diagnosis during pregnancy?","volume":"311","author":"M Lambe","year":"1995","journal-title":"BMJ"},{"issue":"03","key":"ref22","first-page":"207","article-title":"Outcome of pregnancies after cold-knife conization of the uterine cervix during pregnancy","volume":"23","author":"A Demeter","year":"2002","journal-title":"Eur J Gynaecol Oncol"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1080\/14767050500123962","article-title":"Pregnancy-associated cervical cancer: obstetric outcomes","volume":"17","author":"J L Dalrymple","year":"2005","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1097\/AOG.0b013e3181b19154","article-title":"Increasing incidence of pregnancy-associated breast cancer in Sweden","volume":"114","author":"T M-L Andersson","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1111\/tbj.12007","article-title":"Incidence, risk factors, and obstetrical outcomes of women with breast cancer in pregnancy","volume":"18","author":"H A Abenhaim","year":"2012","journal-title":"Breast J"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1111\/bjh.13327","article-title":"Management and controversies of classical Hodgkin lymphoma in pregnancy","volume":"169","author":"T A Eyre","year":"2015","journal-title":"Br J Haematol"},{"issue":"08","key":"ref27","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1001\/jamaoncol.2016.1396","article-title":"Maternal and fetal outcomes after therapy for Hodgkin or non-Hodgkin lymphoma diagnosed during pregnancy","volume":"2","author":"C C Pinnix","year":"2016","journal-title":"JAMA Oncol"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/tbj.13156","article-title":"Neonatal outcomes of pregnancy-associated breast cancer: population-based study on 11 million births","volume":"25","author":"G Shechter Maor","year":"2019","journal-title":"Breast J"},{"issue":"07","key":"ref29","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1515\/jpm-2019-0039","article-title":"Pregnancy outcomes after thyroid cancer","volume":"47","author":"E Spiegel","year":"2019","journal-title":"J Perinat Med"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1200\/JCO.2008.17.4110","article-title":"Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study","volume":"27","author":"H Stensheim","year":"2009","journal-title":"J Clin Oncol"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1158\/1055-9965.EPI-12-1356","article-title":"Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care","volume":"22","author":"J S de Moor","year":"2013","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3322\/caac.21349","article-title":"Cancer treatment and survivorship statistics, 2016","volume":"66","author":"K D Miller","year":"2016","journal-title":"CA Cancer J Clin"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1067\/mob.2002.126643","article-title":"Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study","volume":"187","author":"D M Green","year":"2002","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/S1470-2045(05)70169-8","article-title":"Radiotherapy during pregnancy: fact and fiction","volume":"6","author":"H B Kal","year":"2005","journal-title":"Lancet Oncol"},{"issue":"20","key":"ref36","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1093\/jnci\/djj394","article-title":"Female survivors of childhood cancer: preterm birth and low birth weight among their children","volume":"98","author":"L B Signorello","year":"2006","journal-title":"J Natl Cancer Inst"},{"issue":"05","key":"ref37","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.ijrobp.2008.12.016","article-title":"Impact of radiotherapy on fertility, pregnancy, and neonatal outcomes in female cancer patients","volume":"73","author":"J Y Wo","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"05","key":"ref38","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1002\/ijc.26045","article-title":"Pregnancy after adolescent and adult cancer: a population-based matched cohort study","volume":"129","author":"H Stensheim","year":"2011","journal-title":"Int J Cancer"},{"issue":"03","key":"ref39","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/j.1447-0756.2011.01730.x","article-title":"Pregnant woman with an extremely small uterus due to pelvic irradiation in childhood","volume":"38","author":"T Watanabe","year":"2012","journal-title":"J Obstet Gynaecol Res"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.fertnstert.2014.10.043","article-title":"Adolescent and adult uterine volume and uterine artery Doppler blood flow among subjects treated with bone marrow transplantation or chemotherapy in pediatric age: a case-control study","volume":"103","author":"F Beneventi","year":"2015","journal-title":"Fertil Steril"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1097\/AOG.0000000000000963","article-title":"Contraceptive practices among female cancer survivors of reproductive age","volume":"126","author":"S A Dominick","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"08","key":"ref42","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3390\/cancers11081046","article-title":"A retrospective evaluation of risk of peripartum cardiac dysfunction in survivors of childhood, adolescent and young adult malignancies","volume":"11","author":"L Chait-Rubinek","year":"2019","journal-title":"Cancers (Basel)"},{"issue":"04","key":"ref44","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s10995-007-0256-6","article-title":"An enhanced method for identifying obstetric deliveries: implications for estimating maternal morbidity","volume":"12","author":"E V Kuklina","year":"2008","journal-title":"Matern Child Health J"},{"issue":"01","key":"ref46","doi-asserted-by":"crossref","first-page":"98e1","DOI":"10.1016\/j.ajog.2014.07.018","article-title":"Medical and obstetric complications among pregnant women with cystic fibrosis","volume":"212","author":"E M Patel","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/AOG.0000000000000973","article-title":"Medical and obstetric outcomes among pregnant women with congenital heart disease","volume":"126","author":"J L Thompson","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref51","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s10549-012-2368-y","article-title":"Trastuzumab administration during pregnancy: a systematic review and meta-analysis","volume":"137","author":"F Zagouri","year":"2013","journal-title":"Breast Cancer Res Treat"},{"issue":"09","key":"ref52","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1002\/pds.3495","article-title":"Medications in the first trimester of pregnancy: most common exposures and critical gaps in understanding fetal risk","volume":"22","author":"P G Thorpe","year":"2013","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"05","key":"ref53","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/CCO.0000000000000386","article-title":"Cancer in pregnancy: safety and efficacy of systemic therapies","volume":"29","author":"I Boere","year":"2017","journal-title":"Curr Opin Oncol"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1097\/00005650-200008000-00003","article-title":"Identification of in-hospital complication from claims data identification complications is it valid?","volume":"38","author":"A G Lawthers","year":"2000","journal-title":"Med Care"},{"issue":"02","key":"ref56","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1111\/birt.12411","article-title":"Trends and state variations in out-of-hospital births in the United States, 2004-2017","volume":"46","author":"M F MacDorman","year":"2019","journal-title":"Birth"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1714394.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:09:40Z","timestamp":1641859780000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1714394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,21]]},"references-count":48,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,1,10]]},"published-print":{"date-parts":[[2022,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1714394","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,21]]}}}