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

Fotheringham, P; Safi, N; Li, Z; Anazodo, A; Remond, M; Hayen, A; Currow, D; Roder, D; Hamad, N; Nicholl, M; Gordon, A; Frawley, J; Sullivan, EA

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

Fotheringham, P Safi, N

Li, Z Anazodo, A Remond, M Hayen, A

Currow, D

Roder, D Hamad, N Nicholl, M Gordon, A Frawley, J

Sullivan, EA

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Acta Obstet Gynecol Scand, 2023
Issue Date:: 2023-03-13

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Field	Value	Language
dc.contributor.author	Fotheringham, P
dc.contributor.author	Safi, N https://orcid.org/0000-0001-8473-0980
dc.contributor.author	Li, Z
dc.contributor.author	Anazodo, A
dc.contributor.author	Remond, M
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.contributor.author	Roder, D
dc.contributor.author	Hamad, N
dc.contributor.author	Nicholl, M
dc.contributor.author	Gordon, A
dc.contributor.author	Frawley, J https://orcid.org/0000-0001-6037-0140
dc.contributor.author	Sullivan, EA
dc.date.accessioned	2023-11-06T22:07:05Z
dc.date.available	2023-01-25
dc.date.available	2023-11-06T22:07:05Z
dc.date.issued	2023-03-13
dc.identifier.citation	Acta Obstet Gynecol Scand, 2023
dc.identifier.issn	0001-6349
dc.identifier.issn	1600-0412
dc.identifier.uri	http://hdl.handle.net/10453/173082
dc.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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation	The Cancer Council NSWAPP1141231
dc.relation.ispartof	Acta Obstet Gynecol Scand
dc.relation.isbasedon	10.1111/aogs.14530
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.classification	3215 Reproductive medicine
dc.subject.classification	4204 Midwifery
dc.title	Pregnancy-associated gynecological cancer in New South Wales, Australia 1994-2013: A population-based historical cohort study.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-06T22:07:04Z
pubs.publication-status	Published online

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.

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http://hdl.handle.net/10453/173082