Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort

Prasad L. Gawade, Kevin C. Oeffinger, Charles A. Sklar, Daniel M. Green, Kevin R. Krull, Wassim Chemaitilly, Marilyn Stovall, Wendy Leisenring, Gregory Armstrong, Leslie L. Robison, Kirsten K. Ness

Research output: Contribution to journalArticle

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Abstract

Objective To evaluate associations between prepregnancy lifestyle factors, psychologic distress and adverse pregnancy outcomes among female survivors of childhood cancer.

Study Design We examined pregnancies of 1192 female participants from the Childhood Cancer Survivor Study. Generalized linear models, adjusted for age at diagnosis, age at pregnancy, parity, and education were used to calculate the odds ratio (OR) and confidence interval (CI) for associations between prepregnancy inactivity, overweight or obese status, smoking status, risky drinking, psychologic distress and pregnancy outcomes. Interactions between lifestyle factors, psychologic distress, type of cancer and cancer treatment were assessed in multivariable models.

Results The median age of study participants at the beginning of pregnancy was 28 years (range, 14-45). Among 1858 reported pregnancies, there were 1300 singleton live births (310 were preterm), 21 stillbirths, 397 miscarriages, and 140 medical abortions. Prepregnancy physical inactivity, risky drinking, distress, and depression were not associated with any pregnancy outcomes. Compared with those who had never smoked, survivors with >5 pack-years smoking history had a higher risk for miscarriage among those treated with >2.5 Gray (Gy) uterine radiation (OR, 53.9; 95% CI, 2.2-1326.1) than among those treated with 2.5 Gy uterine radiation (OR, 1.9; 95% CI, 1.2-3.0). There was a significant interaction between smoking and uterine radiation (P;b =.01).

Conclusion Although most lifestyle factors and psychologic distress were not predictive of adverse pregnancy outcomes, the risk for miscarriage was significantly increased among survivors exposed to 2.5 Gy uterine radiation who had a history of smoking.

Original languageEnglish (US)
Pages (from-to)47.e1-47.e10
JournalAmerican Journal of Obstetrics and Gynecology
Volume212
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Pregnancy Outcome
Life Style
Spontaneous Abortion
Cohort Studies
Smoking
Radiation
Pregnancy
Odds Ratio
Confidence Intervals
Drinking
Neoplasms
Stillbirth
Live Birth
Parity
Linear Models
History
Depression
Education

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Gawade, P. L., Oeffinger, K. C., Sklar, C. A., Green, D. M., Krull, K. R., Chemaitilly, W., ... Ness, K. K. (2015). Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort. American Journal of Obstetrics and Gynecology, 212(1), 47.e1-47.e10. https://doi.org/10.1016/j.ajog.2014.07.036

Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort. / Gawade, Prasad L.; Oeffinger, Kevin C.; Sklar, Charles A.; Green, Daniel M.; Krull, Kevin R.; Chemaitilly, Wassim; Stovall, Marilyn; Leisenring, Wendy; Armstrong, Gregory; Robison, Leslie L.; Ness, Kirsten K.

In: American Journal of Obstetrics and Gynecology, Vol. 212, No. 1, 01.01.2015, p. 47.e1-47.e10.

Research output: Contribution to journalArticle

Gawade, PL, Oeffinger, KC, Sklar, CA, Green, DM, Krull, KR, Chemaitilly, W, Stovall, M, Leisenring, W, Armstrong, G, Robison, LL & Ness, KK 2015, 'Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort', American Journal of Obstetrics and Gynecology, vol. 212, no. 1, pp. 47.e1-47.e10. https://doi.org/10.1016/j.ajog.2014.07.036
Gawade, Prasad L. ; Oeffinger, Kevin C. ; Sklar, Charles A. ; Green, Daniel M. ; Krull, Kevin R. ; Chemaitilly, Wassim ; Stovall, Marilyn ; Leisenring, Wendy ; Armstrong, Gregory ; Robison, Leslie L. ; Ness, Kirsten K. / Lifestyle, distress, and pregnancy outcomes in the Childhood Cancer Survivor Study cohort. In: American Journal of Obstetrics and Gynecology. 2015 ; Vol. 212, No. 1. pp. 47.e1-47.e10.
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abstract = "Objective To evaluate associations between prepregnancy lifestyle factors, psychologic distress and adverse pregnancy outcomes among female survivors of childhood cancer.Study Design We examined pregnancies of 1192 female participants from the Childhood Cancer Survivor Study. Generalized linear models, adjusted for age at diagnosis, age at pregnancy, parity, and education were used to calculate the odds ratio (OR) and confidence interval (CI) for associations between prepregnancy inactivity, overweight or obese status, smoking status, risky drinking, psychologic distress and pregnancy outcomes. Interactions between lifestyle factors, psychologic distress, type of cancer and cancer treatment were assessed in multivariable models.Results The median age of study participants at the beginning of pregnancy was 28 years (range, 14-45). Among 1858 reported pregnancies, there were 1300 singleton live births (310 were preterm), 21 stillbirths, 397 miscarriages, and 140 medical abortions. Prepregnancy physical inactivity, risky drinking, distress, and depression were not associated with any pregnancy outcomes. Compared with those who had never smoked, survivors with >5 pack-years smoking history had a higher risk for miscarriage among those treated with >2.5 Gray (Gy) uterine radiation (OR, 53.9; 95{\%} CI, 2.2-1326.1) than among those treated with 2.5 Gy uterine radiation (OR, 1.9; 95{\%} CI, 1.2-3.0). There was a significant interaction between smoking and uterine radiation (P;b =.01).Conclusion Although most lifestyle factors and psychologic distress were not predictive of adverse pregnancy outcomes, the risk for miscarriage was significantly increased among survivors exposed to 2.5 Gy uterine radiation who had a history of smoking.",
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N2 - Objective To evaluate associations between prepregnancy lifestyle factors, psychologic distress and adverse pregnancy outcomes among female survivors of childhood cancer.Study Design We examined pregnancies of 1192 female participants from the Childhood Cancer Survivor Study. Generalized linear models, adjusted for age at diagnosis, age at pregnancy, parity, and education were used to calculate the odds ratio (OR) and confidence interval (CI) for associations between prepregnancy inactivity, overweight or obese status, smoking status, risky drinking, psychologic distress and pregnancy outcomes. Interactions between lifestyle factors, psychologic distress, type of cancer and cancer treatment were assessed in multivariable models.Results The median age of study participants at the beginning of pregnancy was 28 years (range, 14-45). Among 1858 reported pregnancies, there were 1300 singleton live births (310 were preterm), 21 stillbirths, 397 miscarriages, and 140 medical abortions. Prepregnancy physical inactivity, risky drinking, distress, and depression were not associated with any pregnancy outcomes. Compared with those who had never smoked, survivors with >5 pack-years smoking history had a higher risk for miscarriage among those treated with >2.5 Gray (Gy) uterine radiation (OR, 53.9; 95% CI, 2.2-1326.1) than among those treated with 2.5 Gy uterine radiation (OR, 1.9; 95% CI, 1.2-3.0). There was a significant interaction between smoking and uterine radiation (P;b =.01).Conclusion Although most lifestyle factors and psychologic distress were not predictive of adverse pregnancy outcomes, the risk for miscarriage was significantly increased among survivors exposed to 2.5 Gy uterine radiation who had a history of smoking.

AB - Objective To evaluate associations between prepregnancy lifestyle factors, psychologic distress and adverse pregnancy outcomes among female survivors of childhood cancer.Study Design We examined pregnancies of 1192 female participants from the Childhood Cancer Survivor Study. Generalized linear models, adjusted for age at diagnosis, age at pregnancy, parity, and education were used to calculate the odds ratio (OR) and confidence interval (CI) for associations between prepregnancy inactivity, overweight or obese status, smoking status, risky drinking, psychologic distress and pregnancy outcomes. Interactions between lifestyle factors, psychologic distress, type of cancer and cancer treatment were assessed in multivariable models.Results The median age of study participants at the beginning of pregnancy was 28 years (range, 14-45). Among 1858 reported pregnancies, there were 1300 singleton live births (310 were preterm), 21 stillbirths, 397 miscarriages, and 140 medical abortions. Prepregnancy physical inactivity, risky drinking, distress, and depression were not associated with any pregnancy outcomes. Compared with those who had never smoked, survivors with >5 pack-years smoking history had a higher risk for miscarriage among those treated with >2.5 Gray (Gy) uterine radiation (OR, 53.9; 95% CI, 2.2-1326.1) than among those treated with 2.5 Gy uterine radiation (OR, 1.9; 95% CI, 1.2-3.0). There was a significant interaction between smoking and uterine radiation (P;b =.01).Conclusion Although most lifestyle factors and psychologic distress were not predictive of adverse pregnancy outcomes, the risk for miscarriage was significantly increased among survivors exposed to 2.5 Gy uterine radiation who had a history of smoking.

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