{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T07:32:30Z","timestamp":1774596750129,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T00:00:00Z","timestamp":1567036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cancer treatment during childhood may lead to late adverse effects, such as reduced musculoskeletal development or vascular, endocrine and pulmonary dysfunction, which in turn may have an adverse effect on later pregnancy and childbirth. The aim of the present study was to investigate pregnancy and obstetric outcomes as well as the offspring's health among childhood and adolescent female cancer survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This register\u2010based study included all women born between 1973 and 1977 diagnosed with cancer in childhood or adolescence (age &lt;21), as well as an age\u2010matched comparison group. A total of 278 female cancer survivors with their first childbirth were included in the study, together with 829 age\u2010matched individuals from the general population. Logistic regression and analysis of variance were used to investigate associations between having been treated for cancer and the outcome variables, adjusting for maternal age, nicotine use and comorbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Survivors were more likely to have preeclampsia (adjusted odds ratio [<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>] 3.46, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.58 to 7.56), undergo induction of labor (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 1.66, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.05 to 2.62), suffer labor dystocia (primary labor dystocia <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 3.54, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.51 to 8.34 and secondary labor dystocia <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.43, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.37 to 4.31), malpresentation of fetus (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.02, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.12 to 3.65) and imminent fetal asphyxia (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.55, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.49 to 4.39). In addition, deliveries among survivors were more likely to end with vacuum extraction (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.53, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.44 to 4.47), with higher risk of clitoral lacerations (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.18, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.47 to 3.23) and anal sphincter injury (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.76, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.14 to 6.70) and emergency <jats:styled-content style=\"fixed-case\">cesarean section<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.34 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.39 to 3.95). Survivors used pain\u2010reliving methods to a higher extent compared with the comparison group. There was no increased risk of neonate diagnoses and malformations. The results showed that survivors who had been diagnosed with cancer when they were younger than 14 had an increased risk of adverse obstetric outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study demonstrates increased risk of pregnancy and childbirth complications among childhood and adolescent cancer survivors. There is a need to optimize perinatal care, especially among survivors who were younger than 14 at time of diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13690","type":"journal-article","created":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T15:08:33Z","timestamp":1563808113000},"page":"1603-1611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Adverse obstetric outcomes among female childhood and adolescent cancer survivors in Sweden: A population\u2010based matched cohort study"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7927-4041","authenticated-orcid":false,"given":"Gabriela","family":"Armuand","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine Faculty of Health Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agneta","family":"Skoog 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