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Giving taxanes during gestation seems to be safe after the first trimester, as maternal and fetal outcomes are comparable to those of the general neonatal and obstetric populations.
In a systematic review, taxane administration during gestation beyond the first trimester displayed no substantial adverse effects, with maternal and fetal outcomes mirroring those of the general obstetric and neonatal cohorts. Researchers sought to examine neonatal and obstetric outcomes following taxane usage during the pregnancy phase. With the aid of the Web of Sciences, MEDLINE, and CENTRAL databases, a thorough literature search was conducted. Inclusion criteria encompassed individual case data, gestational taxane usage, and original findings presentation. Descriptive statistical analysis was performed.
The study authors recognized 159 females who underwent treatment with taxane-containing regimens during pregnancy, resulting in 162 fetuses exposed in the womb. A considerable proportion of women suffered from cervical cancer (n = 45; 28.3%) or breast cancer (n = 88; 55.3%). The most commonly used taxane was Paclitaxel (n = 131; 82.4%). Furthermore, 111 (69.8%) women received other cytotoxic agents during pregnancy, incorporating platinum salts (n = 70; 63.0%) and Doxorubicin/Cyclophosphamide (n = 20; 18.0%). A substantial percentage of females were given taxanes during the second trimester (n = 79; 70.0%), while two were exposed during the first trimester.
For about 105 (66.0%) women, obstetric outcomes were accessible, with oligohydramnios/anhydramnios (n = 6; 5.7%), pre-eclampsia/HELLP syndrome (n = 6; 5.7%), and preterm uterine contractions or early rupture of membranes (n = 12; 11.4%) being the most common noxious events. All pregnancies with available outcomes resulted in live births (n = 132). Notably, 72 (54.5%) infants were born preterm. Furthermore, 40 (30.3%) were categorized as small for gestational age, and 2 (1.5%) exhibited an Apgar score of < 7 at five minutes.
Perinatal complications incorporated hypoglycemia (n = 2; 1.5%), hyperbilirubinemia (n = 5; 3.8%), and acute respiratory distress syndrome (n = 14; 10.6%). Additionally, 7 (5.3%) instances of congenital malformations were documented. The health status of offspring was available for 86 (65.2%) cases, with 13 (15.1%) experiencing documented complications such as acute myeloid leukemia, recurrent otitis media, and delayed speech development at a median follow-up of sixteen months. After the first trimester of pregnancy, taxanes seem to be safe, with fetal and obstetric outcomes akin to those seen in the general obstetric cohort. Future research must focus on determining the most effective taxane regimen and dosage during gestation, with a particular emphasis on the safety of treatment.
BMC Cancer
Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review
Alejandro Aranda-Gutierrez et al.
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