Fetal Exposure to Chemotherapy May Not Affect the Development of the Child

A new study has given reassuring results for mothers who are under chemotherapy treatment for cancer. The study results show that fetal exposure to chemotherapy after the first trimester may not cause health problems or developmental delays in the child. In this study published in the journal Lancet, children whose mothers had three to four cycles of chemotherapy during pregnancy were subjected to various tests to assess their development of health, behaviour and intelligence. 

Children who had a premature birth scored low in the intelligence tests, but the actual reason behind the low score is thought to be early delivery and not exposure to chemotherapy. According to Researcher Frederic Amant, MD, PhD, of Belgium’s Leuven Cancer Institute, the results show that the practice of planning an early delivery to avoid exposure to the chemotherapy should be avoided. “ After the first trimester, exposure to chemotherapy is safer than a premature delivery," adds Amant.

According to a new study, one in 1,000 pregnant women has malignancies that require treatment. There are very few studies on children born to women who had chemotherapy during pregnancy, until now. In the present study, 70 children who were about 2-years-old and had fetal exposure to chemotherapy were included. Out of this, two-thirds of the children were born prematurely. All the participants were given standard IQ tests, along with tests to assess their heart function, hearing, and physical and behavioral development. 

Except for the IQ scores, all other scores including that of general health, hearing and growth were normal for all the children. Prematurely born children had low scores in the IQ tests. The results show that IQ scores increased by an average of 11 points for each additional month of gestation.

According to Amant, larger studies with a longer follow-up are needed for confirming the findings. The results show that exposure to chemotherapy after the first trimester is generally safe for the baby.

• There is no reason to terminate pregnancy because of chemotherapy
• There is no reason to delay treatment during pregnancy and
• Delivery need not be preponed for fear of exposure to chemotherapy

Women’s cancer specialist Diana Contreras, MD, Director of the division of gynecology oncology at Long Island Jewish Medical Center in New Hyde Park, New York, says that the study confirms what the oncologists believe. The study results are very reassuring and doctors can now refer to the study to convince the parents about what they are telling. Otis Brawley, MD, Chief Medical Officer, American Cancer Society, also agrees with the view. “Some of the chemotherapies, such as the one using drug methotrexate, are generally avoided as they increase the risk of birth defects. But most of the cancer drugs commonly used does not cross the placental barrier," Brawley says.