Granulocyte Colony-Stimulating Factor Use in Pregnant Women with Cancer Requiring Chemotherapy
Year: 2024
Type: preprint
Study design: Observational Study
Abstract: Background Cancer complicates approximately 1 in 1,000 pregnancies. Chemotherapy can be safely administered after the first trimester; however, limited safety data on in utero exposure to granulocyte-colony stimulating factors (G-CSF) may influence chemotherapy regimens offered during pregnancy. This study evaluates neonatal and maternal outcomes following G-CSF exposure during pregnancy and examines the incidence of maternal neutropenia among women receiving chemotherapy. Methods We conducted a prospective cohort study using data from the Cancer and Pregnancy Registry (1997–2023). Outcomes were compared between pregnant women receiving chemotherapy with G-CSF and those receiving chemotherapy alone. Primary neonatal outcomes included birthweight, fetal growth restriction (FGR), neutropenia or leukopenia at birth, congenital anomalies, and pediatric medical conditions. Maternal outcomes included neutropenia and pregnancy complications. Results Among 367 pregnant women receiving chemotherapy, 85 received G-CSF. Mean maternal age at diagnosis was 32.7 years, and mean gestational age at diagnosis was 14 weeks. Breast cancer was the most common diagnosis, and patients with breast cancer were more likely to receive G-CSF than those with other malignancies (p = 0.04). No significant differences were observed between exposed and unexposed groups in birthweight (2,610 g vs 2,720 g; p = 0.13), FGR (29% vs 20%; p = 0.06), neonatal complications (16% vs 18%; p = 0.73), congenital anomalies (13% vs 8%; p = 0.15), neonatal leukopenia (2% vs 2%; p = 1.00), neutropenia (6% vs 5%; p = 0.73), or pediatric medical conditions (31% vs 27%; p = 0.47). Maternal neutropenia occurred in 7.7% of women overall, with no significant difference between those receiving G-CSF and those who did not (p = 0.59). Conclusion Exposure to G-CSF during chemotherapy in pregnancy was not associated with adverse maternal, neonatal, or pediatric outcomes. Trial Registration ClinicalTrials.gov (NCT02749474), registered April 21, 2016. Retrospectively registered.
Source: Research Square
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4403534014