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Published on: November 20, 2015
Long-term neurodevelopmental outcome after prenatal exposure to maternal hematological malignancies with or without
Mathilde van Gerwen1,2, Evangeline Huis In 't Veld1,2, Martine van Grotel2
1Center for Gynecologic Oncology Amsterdam, the Netherlands Cancer Institute, Amsterdam, The Netherlands.
Insights
Children prenatally exposed to maternal hematological cancers and treatments show normal long-term neurodevelopment. However, ongoing emotional surveillance is crucial, particularly if the mother has passed away from cancer.
Area of Science:
- Pediatric Oncology
- Neurodevelopmental Pediatrics
- Maternal Health
Background:
- Limited data exists on long-term neurodevelopmental outcomes for children exposed prenatally to maternal hematological cancers and their treatments.
- Understanding these outcomes is vital for comprehensive pediatric care and long-term follow-up strategies.
Purpose of the Study:
- To evaluate the long-term neurodevelopmental outcomes in children exposed prenatally to maternal hematological malignancies.
- To identify potential correlations between prenatal exposure, treatment, and various neurodevelopmental domains in offspring.
Main Methods:
- A cohort of 57 children with prenatal exposure to hematological malignancies underwent comprehensive neuropsychological and physical examinations across multiple age points (18 months to 18 years).
- Data collection included oncological, obstetrical, neonatal, and follow-up records, alongside parental questionnaires on child's health, behavior, and development.
- Subgroup analyses explored correlations with gestational age and the need for supportive care.
Main Results:
- Cognitive development, including language, intelligence, attention, memory, and behavior, remained within normal ranges at a median age of 10.7 years.
- Gestational age at birth was correlated with cognitive outcomes in early childhood.
- The need for supportive care was associated with maternal loss due to cancer.
Conclusions:
- Prenatal exposure to maternal hematological malignancies, with or without treatment, did not adversely affect long-term neurodevelopment in children.
- Continued monitoring of emotional development is recommended, especially in cases of maternal mortality from cancer.
- Findings support the safety of pregnancy in mothers with hematological cancers, with a focus on psychosocial support.
Abstract:
Data on the long-term neurodevelopmental outcomes of children exposed to hematological maternal cancer with or without treatment during pregnancy are lacking. A total of 57 children, of whom 33 males and 24 females, prenatally exposed to hematological malignancies and its treatment, were invited for neuropsychological and physical examinations at 18 months, 36 months, 6, 9, 12, 15 and 18 years of age. Oncological, obstetrical, neonatal and follow-up data of these children were collected. Parents were asked to complete questionnaires on their child's general health, school performances, social situation, behavioral development, executive functioning, and if their child receives supportive care. Non-Hodgkin lymphoma was diagnosed in 35.1%, Hodgkin lymphoma in 28.1%, acute myeloid leukemia in 15.8%, chronic myeloid leukemia in 12.3%, and acute lymphoblastic leukemia in 8.8%. Cognitive development at a median age of 10.7 years was within the normal range. In subgroup analyses of children in early childhood, the gestational age at birth was correlated with the cognitive outcome at a median age of 1.7 years. Scores for language development, intelligence, attention, memory and behavior, as well as clinical neurological and general pediatric examinations were within normal ranges. In subgroup analyses, the need for supportive care in the child was associated with the loss of the mother. Prenatal exposure to hematological maternal malignancies with or without treatment did not affect the neurodevelopment of the child in the long term. Yet, caution is indicated and surveillance of the emotional development of the child is needed, especially when the mother is deceased to cancer.
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