{
    "abstract": "The main data available on the safety of radiation during pregnancy originate from animal studies and from studies of survivors of atomic or nuclear disasters. The effect of radiotherapy to treat maternal cancer on fetal development is uncertain. This report presents a unique cohort and aims to determine the long-term neurocognitive, psychosocial and physical outcomes of offspring of mothers treated with radiotherapy during pregnancy.\nIn this international, multicentre, mixed retrospective-prospective cohort study, we recruited participants between Aug 5, 2006, and Aug 24, 2023, aged between 1\u00b75 and 46 years, at three referral centres in Belgium, the Netherlands, and the USA. Participants were eligible if they were born from mothers treated with radiotherapy during pregnancy. Fetal radiation doses were obtained from medical records and participants were followed up at predefined ages (1\u00b75, 3, 6, 9, 12, 15, and 18 years) and 5-yearly in adulthood, based on age at enrolment, using a neurocognitive test battery (measuring intelligence, attention, and memory), parent-reported executive function and psychosocial questionnaires, and a medical assessment. Results were compared with test-specific normative data. Linear regression models investigated associations between radiotherapy factors (fetal radiation dose, gestational age at the start and end of radiotherapy, and radiotherapy duration) and outcomes.\n68 maternal cases of radiotherapy during pregnancy were registered by the three participating centres, of which 61 resulted in a livebirth and were therefore eligible to participate in the child follow-up study. After excluding those who did not give consent, 43 participants born from 42 mothers treated with radiotherapy during pregnancy were included in the study (median age at first assessment 3 years [IQR 2-11]; median age at last assessment 12 years [9-18]; median number of assessments two [1-4]). 18 (42%) of the included participants were female and 25 (58%) male, and 37 (86%) were of White ethnicity. Mean neurocognitive outcomes of the entire cohort were within normal ranges. No associations were found with fetal radiation dose or timing of radiotherapy during pregnancy. Six (16%) of 38 participants with neurocognitive outcomes scored lower than one SD on at least one neurocognitive outcome, three (7%) reported chronic medical conditions (spasmophilia, spastic diplegia, and IgG deficiency), and three (7%) were diagnosed with attention-deficit hyperactivity disorder (of whom two scored lower on attention). Of ten (23%) participants with lower neurocognitive score(s), a chronic medical condition, or attention-deficit hyperactivity disorder, eight were born preterm. The remaining 33 (77%) participants showed no neurocognitive, psychosocial, or chronic physical problems.\nWe show on average normal neurocognitive, psychosocial, and physical outcomes after prenatal exposure to radiotherapy. Differences in outcomes could not be explained by exposure to radiotherapy during pregnancy. These results suggest that extra-abdomino-pelvic radiotherapy exposure during pregnancy in general does not adversely affect outcomes of liveborn children. Further research with a larger sample is necessary to confirm these findings.\nKom Op Tegen Kanker, KWF Kankerbestrijding, Stichting Tegen Kanker, Research Foundation Flanders.",
    "authors": [
        {
            "affiliation": "Unit of Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.",
            "firstname": "Indra A",
            "initials": "IA",
            "lastname": "Van Assche"
        },
        {
            "affiliation": "Unit of Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Unit of Foetomaternal Medicine, Department of Obstetrics and Gynaecology, UZ Leuven, Leuven, Belgium.",
            "firstname": "Kristel",
            "initials": "K",
            "lastname": "Van Calsteren"
        },
        {
            "affiliation": "Unit of Paediatric Oncology, Department of Oncology, KU Leuven, Leuven, Belgium; Unit of Paediatric Haemato-Oncology, Department of Paediatrics, UZ Leuven, Leuven, Belgium.",
            "firstname": "Jurgen",
            "initials": "J",
            "lastname": "Lemiere"
        },
        {
            "affiliation": "Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium.",
            "firstname": "Jana",
            "initials": "J",
            "lastname": "Hohmann"
        },
        {
            "affiliation": "Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium; Unit of Gynaecological Oncology, Department of Oncology, KU Leuven, Leuven, Belgium.",
            "firstname": "Jeroen",
            "initials": "J",
            "lastname": "Blommaert"
        },
        {
            "affiliation": "Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, Netherlands; Center for Gynecological Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands.",
            "firstname": "Evangeline A",
            "initials": "EA",
            "lastname": "Huis In 't Veld"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Cooper University Health Care, Camden, NJ, USA.",
            "firstname": "Elyce",
            "initials": "E",
            "lastname": "Cardonick"
        },
        {
            "affiliation": "Unit of Foetomaternal Medicine, Department of Obstetrics and Gynaecology, UZ Leuven, Leuven, Belgium; Unit of Gynaecological Oncology, Department of Oncology, KU Leuven, Leuven, Belgium.",
            "firstname": "Charlotte",
            "initials": "C",
            "lastname": "LeJeune"
        },
        {
            "affiliation": "Department of Medical BioSciences, Radboud University Medical Centre, Nijmegen, Netherlands.",
            "firstname": "Nelleke P B",
            "initials": "NPB",
            "lastname": "Ottevanger"
        },
        {
            "affiliation": "Department of Medical Oncology, University Medical Centre Utrecht, Netherlands.",
            "firstname": "Els P O",
            "initials": "EPO",
            "lastname": "Witteveen"
        },
        {
            "affiliation": "Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, Netherlands.",
            "firstname": "Martine",
            "initials": "M",
            "lastname": "van Grotel"
        },
        {
            "affiliation": "Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, Netherlands; Division of Child Health, University Medical Centre Utrecht-Wilhelmina Children's Hospital, Utrecht, Netherlands.",
            "firstname": "Marry M",
            "initials": "MM",
            "lastname": "van den Heuvel-Eibrink"
        },
        {
            "affiliation": "Unit of Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Unit of Paediatric Neurology, Department of Paediatrics, UZ Leuven, Leuven, Belgium.",
            "firstname": "Lieven",
            "initials": "L",
            "lastname": "Lagae"
        },
        {
            "affiliation": "Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium; Department of Radiation Oncology, UZ Leuven, Leuven, Belgium.",
            "firstname": "Maarten",
            "initials": "M",
            "lastname": "Lambrecht"
        },
        {
            "affiliation": "Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, UZ Leuven, Leuven, Belgium; Unit of Gynaecological Oncology, Department of Oncology, KU Leuven, Leuven, Belgium; Center for Gynecological Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands. Electronic address: frederic.amant@uzleuven.be.",
            "firstname": "Fr\u00e9d\u00e9ric",
            "initials": "F",
            "lastname": "Amant"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 Elsevier Ltd. All rights reserved.",
    "doi": "10.1016/S2352-4642(24)00075-0",
    "journal": "The Lancet. Child & adolescent health",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-04-20",
    "pubmed_id": "38640941",
    "results": null,
    "title": "Long-term neurocognitive, psychosocial, and physical outcomes after prenatal exposure to radiotherapy: a multicentre cohort study of the International Network on Cancer, Infertility, and Pregnancy.",
    "xml": "<Element 'PubmedArticle' at 0x788504252840>"
}