Childbirth after cancer among 42,896 male adolescents and young adults: a population-based study

Abstract

Background Few studies have examined childbirth and adverse perinatal outcomes among male adolescents and young adults with cancer (AYAs, diagnosed at age 15-39 years). We conducted a population-based assessment of these outcomes in a large, diverse sample. Methods Male AYAs diagnosed between January 1, 1995 and December 31, 2015 were identified using the Texas Cancer Registry and linked to live birth certificates and the Texas Birth Defects Registry through December 31, 2016. Cumulative incidence of live birth after diagnosis was estimated. Log binomial regression models were used to estimate prevalence of preterm birth (<37 weeks), low birth weight (<2,500 grams), small for gestational age (<10th percentile), and any birth defect among liveborn offspring of male AYAs compared to age- and race/ethnicity-matched men without cancer. Results We identified 42,896 male AYAs, among whom germ cell cancers (20.0%) were the most common. There were 9,686 live births to 6,833 male AYAs after diagnosis. Cumulative incidence of live birth was 18.0% (95% CI 17.6, 18.4) at ten years after diagnosis. Ten-year cumulative incidence differed by cancer type (p < .01) and was highest for thyroid (27.6%, 95% CI 25.4, 29.9) but lowest for gastrointestinal (9.6%, 95% CI 8.1, 10.6) cancer. Prevalence of preterm birth (8.9 vs. 8.0%, p = .02) and low birth weight (6.0 vs. 5.3%, p = .02) was higher for liveborn offspring of male AYAs compared to men without cancer. There was no difference in prevalence of birth defects (4.9 vs. 4.8%, p = .64). Conclusions Our findings underscore the continued importance of reproductive counseling for AYAs.