Authors:
Haggar F, Pereira G, Preen D, Woods J, Martel G, Boushey R, Mamazza J, Einarsdottir K
Authors notes:
Surgical Endoscopy. 2013:online
Keywords:
Colorectal, Complications, Laparoscopy, Neonatal, Obstetrics
Abstract:
The risks of adverse obstetric outcomes among young women survivors of colorectal cancer (CRC) are uncertain.
Among 627,762 deliveries during the study period, 232 were first pregnancies following CRC.
Whether following laparoscopic or open cancer surgery, these pregnancies were independently associated with a significantly increased risk of antepartum hemorrhage, postpartum hemorrhage, Cesarean delivery, infant low Apgar score, need for neonatal resuscitation, and special care admission.
A history of open (but not laparoscopic) cancer surgery was associated with increased risk of gastrointestinal obstruction during pregnancy and prolonged postpartum hospitalization.
Neither was significantly associated with perinatal death.
Among women with previous CRC, rectal (versus colonic) malignancy was independently associated with a significantly higher risk of overall maternal and neonatal adverse outcomes, as was radiotherapy.
Chemotherapy was independently associated with a marginally but significantly higher risk of overall maternal but not neonatal outcomes.
Open versus laparoscopic cancer surgery was associated with a significantly higher risk of antepartum and postpartum hemorrhage, low Apgar score, need for neonatal resuscitation, and neonatal special care admission.
Previous CRCs, particularly rectal and radiation-treated tumors, appear to confer an increased likelihood of adverse outcomes in subsequent pregnancies.
Laparoscopic technique for CRC surgery may reduce adverse gestational outcomes.