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Published on: March 6, 2018
Long-Term Neurodevelopmental Outcome of Children after in Utero Exposure to Chemotherapy
Anna-Maria Korakiti1, Eleni Zografos1, Mathilde van Gerwen2,3
1Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Insights
Prenatal chemotherapy exposure generally shows no major negative effects on child neurodevelopment. Further large-scale studies are needed to confirm these findings for pregnancy-related cancer management.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Oncology
Background:
- Managing cancer during pregnancy presents significant challenges for patients and clinicians.
- Assessing the long-term neurodevelopmental effects on children exposed to chemotherapy in utero is a recent area of research.
Purpose of the Study:
- To systematically review and synthesize existing literature on the impact of prenatal chemotherapy exposure on fetal brain development and child neurodevelopment.
- To consolidate current data on the safety of anti-cancer drugs during pregnancy for offspring neurodevelopment.
Main Methods:
- Systematic literature review of 17 studies.
- Inclusion of studies utilizing validated neurodevelopmental assessment tools (e.g., Bayley Scales, WPPSI) and/or standardized questionnaires.
- Focus on research addressing in utero exposure to chemotherapeutic agents.
Main Results:
- The review of 17 studies found no significant adverse neurodevelopmental consequences in children exposed to chemotherapy in utero.
- Current data suggests that prenatal exposure to anti-cancer drugs does not lead to major developmental issues.
Conclusions:
- While current evidence is reassuring, definitive conclusions require longer-term follow-up.
- Large-scale, multicenter prospective studies are essential to firmly establish the neurodevelopmental outcomes for children exposed to chemotherapy during gestation.
Abstract:
Pregnancy-related cancer management represents a real challenge for both the patients and the physicians. The long-term neurodevelopmental outcome of children in utero exposed to chemotherapeutic agents has only recently been addressed. This review aims to systematically integrate and highlight all existing data from the literature regarding the effect of prenatal exposure to chemotherapy on fetal brain growth and child development. All eligible studies are based on validated neurodevelopmental testing scales (e.g., Bayley Scales of Infant Development, Wechsler Preschool and Primary Scale of Intelligence) and/or well-defined questionnaires. Our systematic review including 17 studies demonstrates that no major consequences on the neurodevelopment of children after in utero exposure to anti-cancer drugs have been reported; nevertheless, longer and more thorough follow-up with large-scale multicenter prospective studies is certainly required in order to draw firm conclusions.
