The offspring of adolescent and young adult women with a history of cancer face a higher risk of birth defects, according to new research from UTHealth Houston.

A study led by Caitlin C. Murphy, PhD, MPH, associate professor of health promotion and behavioral sciences at UTHealth Houston School of Public Health, was published recently in Cancer Epidemiology, Biomarkers & Prevention.

“Concerns like the health of future children are at the top of mind for many young adults diagnosed with cancer, but they are already so overwhelmed at the time of diagnosis with navigating cancer-related information,” said Murphy, who was first author of the study. “Our findings can be used in clinical practice to provide counseling and inform this population of the potential risks and reproductive consequences of cancer, at the time of diagnosis and beyond.”

Researchers examined birth defects in 6,882 offspring, ages 12 months and younger, of women ages 15-39 at the time of cancer diagnosis, between 1999 and 2015. Common cancer types were thyroid (28.9%), lymphoma (12.5%), and breast (10.7%), and 24% of women received chemotherapy.

Overall, risk of any birth defect was higher in offspring of women with a history of cancer (6.0%) compared to offspring of women without cancer (4.8%), although rare in both groups.

There was also an increased risk of specific types of defects in the offspring of women with a history of cancer, including eye or ear (1.39 times more likely), heart and circulatory (1.32 times more likely), genitourinary (1.38 times more likely), and musculoskeletal defects (1.37 times more likely).

Although birth defects are rare, Murphy said young women making decisions about pregnancy and prenatal care should receive appropriate counseling and surveillance. Screening offspring for birth defects could also provide an opportunity for targeted prevention, she said.

“Many studies now demonstrate relationships between cancer and birth defects; children with birth defects also have a higher risk of cancer,” Murphy said. “The more we learn about how they are related to each other, the more we can identify opportunities to prevent both.”

Philip J. Lupo, PhD, with Baylor College of Medicine, was senior author of the study. Co-authors with UTHealth Houston School of Public Health include Andrea C. Betts, MPH; Marlyn A. Allicock, PhD, MPH; L. Aubree Shay, PhD, MSSW, in San Antonio; and PhD student Jennifer S. Wang. Other co-authors included Sandi L. Pruitt, PhD, with UT Southwestern Medical Center; and Barbara A. Cohn, PhD, MPH, with Public Health Institute in Berkeley, California.

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