No Long-Term Impairment From Prenatal Exposure to Chemo

Although children exposed to chemo in utero who are born preterm have impaired cognitive development

FRIDAY, Feb. 10 (HealthDay News) -- General health outcomes and central nervous system, cardiac, and auditory morbidity are not affected by fetal exposure to chemotherapy over the long term, although premature infants exposed to chemotherapy in utero experience impaired cognitive development, according to a study published online Feb. 10 in The Lancet Oncology.

Frédéric Amant, Ph.D., from the Leuven Cancer Institute in Belgium, and colleagues investigated the effect of prenatal exposure to chemotherapy on general health, cardiac function, and neurodevelopmental outcomes. Seventy children, from 68 pregnancies, born at a median gestational age of 35.7 weeks, were assessed at birth, at age 18 months, and at 5 to 6, 8 to 9, 11 to 12, 14 to 15, and 18 years. The median follow-up period was 22.3 months (range, 16.8 to 211.6 months).

The investigators found that the children who were born preterm had neurocognitive outcomes within normal ranges, but had lower cognitive development scores compared with those born at full term. The score for IQ increased significantly, by an average of 11.6 points, for each additional month of gestation, after controlling for age, sex, and country. Measures of behavior, general health, hearing, and growth were comparable to those of the general population, and cardiac dimensions and function fell within the normal range. In both members of the one twin pregnancy, there was a severe neurodevelopmental delay.

"Despite prenatal exposure to chemotherapy, radiotherapy, staging examinations, and co-medications, the outcome for children in our study is not different from the general population," the authors write. "In our cohort, we confirmed the negative prognostic effect of prematurity on cognitive development."

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