Pregnancy-associated colon and rectal cancer: perinatal and cancer outcomes

Abstract

Objective: Assess the impact of colorectal cancer on maternal and neonatal outcomes.

Methods: Cases were identified using several computer-generated linkage analyses. Maternal and newborn hospital discharges in California were linked to birth and if applicable infant death certificate records. This database was then linked to the California Cancer Registry, to create a cohort of women with pregnancy-associated colon and rectal cancer. This cohort was compared to pregnant women in California without colorectal cancer. Our secondary comparison was to non-pregnant, Californian women with colorectal cancer who could be aged-matched.

Results: Women with pregnancy-associated colorectal cancer were more likely to undergo cesarean section (OR: 1.9) and to develop puerperal infections (OR: 2.8). In addition, higher rates of preterm delivery were found both secondary to scheduled deliveries and preterm labor (OR for preterm labor, 2.8). Neonatal outcomes were fairly similar between the two groups. Pregnancy was not found to have a significant effect on survival (HR: 0.73).

Conclusions: We found that women with pregnancy-associated colorectal cancer had excellent maternal and neonatal outcomes. This is likely secondary to the fact that most women are diagnosed after delivery. In addition, survival is similar between pregnancy-associated and non-pregnancy associated cases.