Prevalence of preterm, low birthweight, and small for gestational age delivery after breast cancer diagnosis: A population-based study

Kristin Zene� Black, Hazel B. Nichols, Eugenia Eng, Diane Louise Rowley

Research output: Contribution to journalArticle

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Abstract

Background: Black-white disparities in breast cancer incidence rates and birth outcomes raise concerns about potential disparities in the reproductive health of premenopausal breast cancer survivors. We examined the prevalence of preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) by breast cancer history and effect modification by race. Methods: We analyzed linked North Carolina birth records and Central Cancer Registry files from 1990 to 2009 (n = 2,325,229). We used multivariable negative log-binomial regression to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between breast cancer history and PTB, LBW, and SGA. Results: Of 1,912,269 eligible births, 512 births were to mothers with a previous breast cancer diagnosis history. Average age at breast cancer diagnosis was 31.8 years (SD = 4.7). Mean time from diagnosis to delivery was 3.3 years (SD = 2.8). After multivariable adjustment, the PR was 1.67 (95% CI, 1.42-1.97) for PTB, 1.50 (95% CI, 1.23-1.84) for LBW, and 1.30 (95% CI, 1.05-1.61) for SGA comparing women with a breast cancer history to the general population. Among black mothers, the PRs associated with breast cancer history for PTB, LBW, and SGA were 1.31 (95% CI, 1.00-1.72), 1.49 (95% CI, 1.14-1.94), and 1.44 (95% CI, 1.11-1.87), respectively. The corresponding PRs among white mothers were 2.06 (95% CI, 1.67-2.54), 1.53 (95% CI, 1.12-2.08), and 1.10 (95% CI, 0.77-1.58), respectively. The interaction between breast cancer history and race was statistically significant for associations with PTB, but not for LBW or SGA. Conclusions: In our data, women with a breast cancer history were at higher risk of delivering a PTB, LBW, or SGA infant, especially if they received chemotherapy or gave birth within 2 years of their breast cancer diagnosis date.

LanguageEnglish (US)
Article number11
JournalBreast Cancer Research
Volume19
Issue number1
DOIs
StatePublished - Jan 31 2017

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Gestational Age
Breast Neoplasms
Confidence Intervals
Premature Birth
Population
Mothers
Parturition
Small for Gestational Age Infant
Birth Certificates
Social Adjustment
Birth Rate
Reproductive Health
Survivors
Registries
History
Drug Therapy
Incidence

Keywords

  • Breast cancer
  • Low birthweight
  • Premenopausal
  • Preterm birth
  • Racial disparities
  • Small for gestational age

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Prevalence of preterm, low birthweight, and small for gestational age delivery after breast cancer diagnosis : A population-based study. / Black, Kristin Zene�; Nichols, Hazel B.; Eng, Eugenia; Rowley, Diane Louise.

In: Breast Cancer Research, Vol. 19, No. 1, 11, 31.01.2017.

Research output: Contribution to journalArticle

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abstract = "Background: Black-white disparities in breast cancer incidence rates and birth outcomes raise concerns about potential disparities in the reproductive health of premenopausal breast cancer survivors. We examined the prevalence of preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) by breast cancer history and effect modification by race. Methods: We analyzed linked North Carolina birth records and Central Cancer Registry files from 1990 to 2009 (n = 2,325,229). We used multivariable negative log-binomial regression to calculate prevalence ratios (PRs) and 95{\%} confidence intervals (CIs) for the association between breast cancer history and PTB, LBW, and SGA. Results: Of 1,912,269 eligible births, 512 births were to mothers with a previous breast cancer diagnosis history. Average age at breast cancer diagnosis was 31.8 years (SD = 4.7). Mean time from diagnosis to delivery was 3.3 years (SD = 2.8). After multivariable adjustment, the PR was 1.67 (95{\%} CI, 1.42-1.97) for PTB, 1.50 (95{\%} CI, 1.23-1.84) for LBW, and 1.30 (95{\%} CI, 1.05-1.61) for SGA comparing women with a breast cancer history to the general population. Among black mothers, the PRs associated with breast cancer history for PTB, LBW, and SGA were 1.31 (95{\%} CI, 1.00-1.72), 1.49 (95{\%} CI, 1.14-1.94), and 1.44 (95{\%} CI, 1.11-1.87), respectively. The corresponding PRs among white mothers were 2.06 (95{\%} CI, 1.67-2.54), 1.53 (95{\%} CI, 1.12-2.08), and 1.10 (95{\%} CI, 0.77-1.58), respectively. The interaction between breast cancer history and race was statistically significant for associations with PTB, but not for LBW or SGA. Conclusions: In our data, women with a breast cancer history were at higher risk of delivering a PTB, LBW, or SGA infant, especially if they received chemotherapy or gave birth within 2 years of their breast cancer diagnosis date.",
keywords = "Breast cancer, Low birthweight, Premenopausal, Preterm birth, Racial disparities, Small for gestational age",
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T1 - Prevalence of preterm, low birthweight, and small for gestational age delivery after breast cancer diagnosis

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AU - Black,Kristin Zene�

AU - Nichols,Hazel B.

AU - Eng,Eugenia

AU - Rowley,Diane Louise

PY - 2017/1/31

Y1 - 2017/1/31

N2 - Background: Black-white disparities in breast cancer incidence rates and birth outcomes raise concerns about potential disparities in the reproductive health of premenopausal breast cancer survivors. We examined the prevalence of preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) by breast cancer history and effect modification by race. Methods: We analyzed linked North Carolina birth records and Central Cancer Registry files from 1990 to 2009 (n = 2,325,229). We used multivariable negative log-binomial regression to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between breast cancer history and PTB, LBW, and SGA. Results: Of 1,912,269 eligible births, 512 births were to mothers with a previous breast cancer diagnosis history. Average age at breast cancer diagnosis was 31.8 years (SD = 4.7). Mean time from diagnosis to delivery was 3.3 years (SD = 2.8). After multivariable adjustment, the PR was 1.67 (95% CI, 1.42-1.97) for PTB, 1.50 (95% CI, 1.23-1.84) for LBW, and 1.30 (95% CI, 1.05-1.61) for SGA comparing women with a breast cancer history to the general population. Among black mothers, the PRs associated with breast cancer history for PTB, LBW, and SGA were 1.31 (95% CI, 1.00-1.72), 1.49 (95% CI, 1.14-1.94), and 1.44 (95% CI, 1.11-1.87), respectively. The corresponding PRs among white mothers were 2.06 (95% CI, 1.67-2.54), 1.53 (95% CI, 1.12-2.08), and 1.10 (95% CI, 0.77-1.58), respectively. The interaction between breast cancer history and race was statistically significant for associations with PTB, but not for LBW or SGA. Conclusions: In our data, women with a breast cancer history were at higher risk of delivering a PTB, LBW, or SGA infant, especially if they received chemotherapy or gave birth within 2 years of their breast cancer diagnosis date.

AB - Background: Black-white disparities in breast cancer incidence rates and birth outcomes raise concerns about potential disparities in the reproductive health of premenopausal breast cancer survivors. We examined the prevalence of preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) by breast cancer history and effect modification by race. Methods: We analyzed linked North Carolina birth records and Central Cancer Registry files from 1990 to 2009 (n = 2,325,229). We used multivariable negative log-binomial regression to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between breast cancer history and PTB, LBW, and SGA. Results: Of 1,912,269 eligible births, 512 births were to mothers with a previous breast cancer diagnosis history. Average age at breast cancer diagnosis was 31.8 years (SD = 4.7). Mean time from diagnosis to delivery was 3.3 years (SD = 2.8). After multivariable adjustment, the PR was 1.67 (95% CI, 1.42-1.97) for PTB, 1.50 (95% CI, 1.23-1.84) for LBW, and 1.30 (95% CI, 1.05-1.61) for SGA comparing women with a breast cancer history to the general population. Among black mothers, the PRs associated with breast cancer history for PTB, LBW, and SGA were 1.31 (95% CI, 1.00-1.72), 1.49 (95% CI, 1.14-1.94), and 1.44 (95% CI, 1.11-1.87), respectively. The corresponding PRs among white mothers were 2.06 (95% CI, 1.67-2.54), 1.53 (95% CI, 1.12-2.08), and 1.10 (95% CI, 0.77-1.58), respectively. The interaction between breast cancer history and race was statistically significant for associations with PTB, but not for LBW or SGA. Conclusions: In our data, women with a breast cancer history were at higher risk of delivering a PTB, LBW, or SGA infant, especially if they received chemotherapy or gave birth within 2 years of their breast cancer diagnosis date.

KW - Breast cancer

KW - Low birthweight

KW - Premenopausal

KW - Preterm birth

KW - Racial disparities

KW - Small for gestational age

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