Direct and indirect effects on child neurocognitive development when maternal cancer is diagnosed during pregnancy: What do we know so far?

Crit Rev Oncol Hematol. 2022 Nov:179:103824. doi: 10.1016/j.critrevonc.2022.103824. Epub 2022 Sep 26.

Abstract

Cancer during pregnancy threatens the lives of mother and foetus and its incidence is rising, making it an emerging medical challenge. Evidence on the direct impact of cancer therapies on neonatal outcomes resulted in general guidelines for maternal treatment that safeguards foetal development. Less focus has been placed on indirect factors, in pre- and postnatal periods, that may exert long-term impacts specifically on child neurocognition. Foetal development, in the context of maternal cancer during pregnancy, may be influenced directly by exposure to cancer diagnostics and (co-)treatment, or indirectly through maternal inflammation, malnutrition, hormonal fluctuations, prematurity, and psycho-biological stress. Maternal stress and insecure mother-infant bonding related to postpartum cancer treatment may further impact child cognitive-behavioural development. Understanding the independent and synergistic effects of the factors impacting neurocognitive development creates the opportunity to intervene during the oncological treatment to improve the child's long-term outcome, both by medical and psychosocial care and support.

Keywords: Cancer in pregnancy; Cancer treatment impact on neonatal outcomes; Foetal programming; Indirect effects of cancer treatment; Insecure mother-infant bonding; Neurocognitive development; Postnatal cancer treatment; Prenatal cancer treatment.

Publication types

  • Review

MeSH terms

  • Child
  • Female
  • Fetal Development
  • Fetus
  • Humans
  • Infant
  • Infant, Newborn
  • Mothers / psychology
  • Neoplasms* / complications
  • Neoplasms* / diagnosis
  • Neoplasms* / therapy
  • Pregnancy
  • Prenatal Exposure Delayed Effects* / diagnosis
  • Prenatal Exposure Delayed Effects* / etiology
  • Prenatal Exposure Delayed Effects* / psychology