Reproductive and pregnancy-related outcomes among adolescent and young adult female cancer survivors (15–39 years): A nationwide population-based study in South Korea.

Abstract

12104 Background: As survival rates among adolescent and young adult (AYA) female cancer patients improve, increasing numbers of survivors pursue pregnancy and childbirth. However, population-level data on reproductive outcomes and pregnancy-related complications among female cancer survivors remain limited. Methods: This study collected de-identified data from the South Korean National Health Insurance Service Database. Among 95,264 women aged 15–39 years newly diagnosed with cancer between 2007 and 2010, we identified 58,107 eligible survivors. This cohort was age-matched 1:10 with 719,213 women without cancer. Reproductive outcomes were assessed in the full cohort, and pregnancy-related complications were evaluated among women with documented pregnancies. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. Results: Compared with matched controls, female cancer survivors had a higher risk of infertility (OR 1.25; 95% CI 1.21–1.28) and lower odds of pregnancy (OR 0.94; 95% CI 0.93–0.96) and childbirth (OR 0.81; 95% CI 0.78–0.84). Among women who became pregnant, cancer survivors experienced higher risks of ectopic pregnancy (OR 1.20; 95% CI 1.11–1.29), miscarriage or abortion (OR 1.23; 95% CI 1.14–1.32), intrauterine infection (OR 1.26; 95% CI 1.01–1.57), and preterm labor (OR 1.21; 95% CI 1.14–1.29). Conclusions: AYA female cancer survivors face increased risks of infertility and adverse pregnancy-related outcomes. These findings highlight the need for specialized reproductive counselling and high-risk obstetric care for female cancer survivors. Reproductive outcomes in the full matched cohort and pregnancy-related outcomes among the pregnancy cohort. Outcomes, No. (%) Survivor (N=58,107) Control (N=719,213) OR 95% CI Reproductive Outcomes Infertility 5,439 (9.4) 55,111 (7.7) 1.245 1.209 1.282 Pregnancy 16,974 (29.2) 218,901 (30.4) 0.944 0.926 -0.961 Childbirth 10,912 (18.8) 98,229 (20.8) 0.810 0.780 -0.842 Pregnancy-related Outcomes Ectopic pregnancy 783 (4.6%) 8,495 (3.9%) 1.198 1.111 -1.291 Miscarriage / abortion 866 (5.1%) 9,182 (4.2%) 1.228 1.143 -1.319 Preeclampsia / eclampsia 507 (3.0%) 6,488 (3.0%) 1.008 0.920 -1.105 Gestational diabetes 3,139 (18.5%) 40,317 (18.4%) 1.055 0.965 -1.046 Intrauterine infection 85 (0.5%) 872 (0.4%) 1.259 1.007 -1.574 Premature Rupture of Membranes / amniotic fluid disorders 2,131 (12.6%) 28,002 (12.8%) 0.978 0.933 -1.025 Placental disorders 238 (1.4%) 2,776 (1.3%) 1.107 0.969 -1.265 Preterm labor 1,168(6.9%) 12,601 (5.8%) 1.210 1.137 -1.287 CI, confidence interval; No., number; OR, odds ratio.