Chapter 20 - Long-term neurodevelopment of children exposedin uteroto treatment for maternal cancer

Summary

This chapter provides the available knowledge on children's long-term outcomes to assist women and healthcare professionals in making informed, evidence-based decisions for the management of cancer in pregnancy. Malignant conditions during pregnancy are believed to be associated with an increase in poor perinatal and fetal outcomes due to maternal disorder and treatment. Surgical interventions may be required for both the diagnosis and treatment of certain malignancies. Surgery during pregnancy may also be associated with hypotension, hypoxia, coagulation, metabolic disturbances, and decreased utero-placental perfusion, most secondary to prolonged maintenance in the supine position. Cancer treatment protocols require the use of chemotherapy and/or radiation as well as immunosuppressive agents. The ability of cyclosporine to inhibit T-cell activation has been shown to have a role in the treatment of other diseases such as aplastic anemia. More evidence-based information on long-term neurodevelopmental and behavioral outcomes after exposure to radiation and corticosteroids is required.