Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study

Abstract Introduction Pregnancy‐associated gynecological cancer (PAGC) refers to cancers of the ovary, uterus, fallopian tube, cervix, vagina, and vulva diagnosed during pregnancy or within 12 months postpartum. We aimed to describe the incidence of, and perinatal outcomes associated with, invasive...

Full description

Saved in:
Bibliographic Details
Main Authors: Penelope Fotheringham, Nadom Safi, Zhouyang Li, Antoinette Anazodo, Marc Remond, Andrew Hayen, David Currow, David Roder, Nada Hamad, Michael Nicholl, Adrienne Gordon, Jane Frawley, Elizabeth A. Sullivan
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:Acta Obstetricia et Gynecologica Scandinavica
Subjects:
Online Access:https://doi.org/10.1111/aogs.14530
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850211782783664128
author Penelope Fotheringham
Nadom Safi
Zhouyang Li
Antoinette Anazodo
Marc Remond
Andrew Hayen
David Currow
David Roder
Nada Hamad
Michael Nicholl
Adrienne Gordon
Jane Frawley
Elizabeth A. Sullivan
author_facet Penelope Fotheringham
Nadom Safi
Zhouyang Li
Antoinette Anazodo
Marc Remond
Andrew Hayen
David Currow
David Roder
Nada Hamad
Michael Nicholl
Adrienne Gordon
Jane Frawley
Elizabeth A. Sullivan
author_sort Penelope Fotheringham
collection DOAJ
description Abstract Introduction Pregnancy‐associated gynecological cancer (PAGC) refers to cancers of the ovary, uterus, fallopian tube, cervix, vagina, and vulva diagnosed during pregnancy or within 12 months postpartum. We aimed to describe the incidence of, and perinatal outcomes associated with, invasive pregnancy‐associated gynecological cancer. Material and methods We conducted a population‐based historical cohort study using linked data from New South Wales, Australia. We included all women who gave birth between 1994 and 2013, with a follow‐up period extending to September 30, 2018. Three groups were analyzed: a gestational PAGC group (women diagnosed during pregnancy), a postpartum PAGC group (women diagnosed within 1 year of giving birth), and a control group (women with control diagnosis during pregnancy or within 1 year of giving birth). We used generalized estimation equations to compare perinatal outcomes between study groups. Results There were 1 786 137 deliveries during the study period; 70 women were diagnosed with gestational PAGC and 191 with postpartum PAGC. The incidence of PAGC was 14.6/100 000 deliveries and did not change during the study period. Women with gestational PAGC (adjusted odds ratio [aAOR] 6.81, 95% confidence interval [CI] 2.97–15.62) and with postpartum PAGC (aOR 2.65, 95% CI 1.25–5.61) had significantly increased odds of a severe maternal morbidity outcome compared with the control group. Babies born to women with gestational PAGC were more likely to be born preterm (aOR 3.11, 95% CI 1.47–6.59) and were at increased odds of severe neonatal complications (aOR 3.47, 95% CI 1.45–8.31) compared with babies born to women without PAC. Conclusions The incidence of PAGC has not increased over time perhaps reflecting, in part, the effectiveness of cervical screening and early impacts of human papillomavirus vaccination programs in Australia. The higher rate of preterm birth among the gestational PAGC group is associated with adverse outcomes in babies born to these women.
format Article
id doaj-art-9955835540ec48cb953fb76a8f761274
institution OA Journals
issn 0001-6349
1600-0412
language English
publishDate 2024-04-01
publisher Wiley
record_format Article
series Acta Obstetricia et Gynecologica Scandinavica
spelling doaj-art-9955835540ec48cb953fb76a8f7612742025-08-20T02:09:29ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-04-01103472973910.1111/aogs.14530Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort studyPenelope Fotheringham0Nadom Safi1Zhouyang Li2Antoinette Anazodo3Marc Remond4Andrew Hayen5David Currow6David Roder7Nada Hamad8Michael Nicholl9Adrienne Gordon10Jane Frawley11Elizabeth A. Sullivan12College of Health, Medicine and Wellbeing University of Newcastle Callaghan New South Wales AustraliaCollege of Health, Medicine and Wellbeing University of Newcastle Callaghan New South Wales AustraliaCollege of Health, Medicine and Wellbeing University of Newcastle Callaghan New South Wales AustraliaNelune Comprehensive Cancer Centre Prince of Wales Hospital Randwick New South Wales AustraliaCollege of Health, Medicine and Wellbeing University of Newcastle Callaghan New South Wales AustraliaSchool of Public Health University of Technology Sydney Ultimo New South Wales AustraliaFaculty of Science, Medicine and Health University of Wollongong Wollongong New South Wales AustraliaPopulation Health, Beat Cancer Project University of South Australia Adelaide South Australia AustraliaThe Kinghorn Cancer Centre Darlinghurst New South Wales AustraliaFaculty of Medicine and Health The University of Sydney Camperdown New South Wales AustraliaFaculty of Medicine and Health The University of Sydney Camperdown New South Wales AustraliaSchool of Public Health University of Technology Sydney Ultimo New South Wales AustraliaCollege of Health, Medicine and Wellbeing University of Newcastle Callaghan New South Wales AustraliaAbstract Introduction Pregnancy‐associated gynecological cancer (PAGC) refers to cancers of the ovary, uterus, fallopian tube, cervix, vagina, and vulva diagnosed during pregnancy or within 12 months postpartum. We aimed to describe the incidence of, and perinatal outcomes associated with, invasive pregnancy‐associated gynecological cancer. Material and methods We conducted a population‐based historical cohort study using linked data from New South Wales, Australia. We included all women who gave birth between 1994 and 2013, with a follow‐up period extending to September 30, 2018. Three groups were analyzed: a gestational PAGC group (women diagnosed during pregnancy), a postpartum PAGC group (women diagnosed within 1 year of giving birth), and a control group (women with control diagnosis during pregnancy or within 1 year of giving birth). We used generalized estimation equations to compare perinatal outcomes between study groups. Results There were 1 786 137 deliveries during the study period; 70 women were diagnosed with gestational PAGC and 191 with postpartum PAGC. The incidence of PAGC was 14.6/100 000 deliveries and did not change during the study period. Women with gestational PAGC (adjusted odds ratio [aAOR] 6.81, 95% confidence interval [CI] 2.97–15.62) and with postpartum PAGC (aOR 2.65, 95% CI 1.25–5.61) had significantly increased odds of a severe maternal morbidity outcome compared with the control group. Babies born to women with gestational PAGC were more likely to be born preterm (aOR 3.11, 95% CI 1.47–6.59) and were at increased odds of severe neonatal complications (aOR 3.47, 95% CI 1.45–8.31) compared with babies born to women without PAC. Conclusions The incidence of PAGC has not increased over time perhaps reflecting, in part, the effectiveness of cervical screening and early impacts of human papillomavirus vaccination programs in Australia. The higher rate of preterm birth among the gestational PAGC group is associated with adverse outcomes in babies born to these women.https://doi.org/10.1111/aogs.14530cancer in pregnancygynecological canceriatrogenic prematuritymaternal outcomeneonatal outcomeperinatal outcome
spellingShingle Penelope Fotheringham
Nadom Safi
Zhouyang Li
Antoinette Anazodo
Marc Remond
Andrew Hayen
David Currow
David Roder
Nada Hamad
Michael Nicholl
Adrienne Gordon
Jane Frawley
Elizabeth A. Sullivan
Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study
Acta Obstetricia et Gynecologica Scandinavica
cancer in pregnancy
gynecological cancer
iatrogenic prematurity
maternal outcome
neonatal outcome
perinatal outcome
title Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study
title_full Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study
title_fullStr Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study
title_full_unstemmed Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study
title_short Pregnancy‐associated gynecological cancer in New South Wales, Australia 1994–2013: A population‐based historical cohort study
title_sort pregnancy associated gynecological cancer in new south wales australia 1994 2013 a population based historical cohort study
topic cancer in pregnancy
gynecological cancer
iatrogenic prematurity
maternal outcome
neonatal outcome
perinatal outcome
url https://doi.org/10.1111/aogs.14530
work_keys_str_mv AT penelopefotheringham pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT nadomsafi pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT zhouyangli pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT antoinetteanazodo pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT marcremond pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT andrewhayen pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT davidcurrow pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT davidroder pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT nadahamad pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT michaelnicholl pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT adriennegordon pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT janefrawley pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy
AT elizabethasullivan pregnancyassociatedgynecologicalcancerinnewsouthwalesaustralia19942013apopulationbasedhistoricalcohortstudy