Being a mother after a cancer diagnosis during pregnancy: Maternal psychosocial functioning and child cognitive development and behavior

Abstract

ObjectiveUp to 51.5% of women diagnosed with cancer during pregnancy experience trauma (eg, intrusive thoughts, avoidance) and 20% report anxiety. Maternal anxiety can negatively affect child behavior among the noncancer population. This study aims to elucidate relationships between maternal distress, parenting style, and child behavior and development among women with cancer during pregnancy.MethodsThis cross‐sectional study of child cognitive, language and motor development analyze child behavior in the context of maternal psychosocial well‐being after a cancer diagnosis during pregnancy. A subset of women (N = 69) enrolled in the Cancer and Pregnancy Registry, had children undergo developmental testing. The majority underwent Bayley Scales III (children 6‐42 months of age; 0‐3.5 years) to assess language, cognitive, and motor performance. Women completed the Basic Symptom Inventory, Impact of Events Scale, Parent Behavior Checklist, and Child Behavioral Checklist. Maternal and child assessments were performed concurrently.ResultsSixty‐nine women and 71 children (2 sets of twins) ages 6 months to 12 years participated. Maternal depressive and somatic symptoms were associated with more externalizing behaviors. Among younger children (0‐3.5 years), maternal somatic symptoms were associated with poorer language performance. Moderation analysis showed that mothers with fewer somatic symptoms and utilization of less discipline had children with less externalizing behaviors and higher language scores (ie, stronger verbal ability).ConclusionsGiven the interplay of psychosocial factors on child behavior and development, findings highlight the importance of early screening and psychosocial intervention and support for mothers diagnosed with cancer in pregnancy.

The impact of cancer and chemotherapy during pregnancy on child neurodevelopment: A multimodal neuroimaging analysis

“…Platinum derivatives during pregnancy were indicated as a potential risk factor for decreased cortical gyrification of the left superior temporal gyrus. However, chemotherapy during pregnancy in general did not significantly contribute to these findings, resonating with earlier findings [ 14 , 19 ] describing the role of the psychosocial impact of cancer during pregnancy on the neurocognitive functioning of the child. Balancing between pros and cons on the use of chemotherapy during pregnancy, the current data favour the use of chemotherapy during pregnancy when clinically indicated.…”

“…The psychosocial impact of a cancer diagnosis during pregnancy might partially explain these findings. A recent study identified maternal death as a potential risk factor in their findings of decreased verbal intelligence in children born after cancer-complicated pregnancies [14] and another study described a relationship between infant behavioural functioning and maternal psychological wellbeing [19] . However, given that only 12/42 mothers in the study group did not receive chemotherapy during pregnancy and the heterogeneity of chemotherapy regimens used, we cannot exclude that some chemotherapeutics might directly or indirectly affect neurodevelopment.…”

“…However, when assessing the neurocognitive impact of prenatal cancer treatment exposure, secondary effects such as low birth weight, prematurity and maternal malnutrition, depression, stress and anxiety might also impact neurodevelopment [17] . It has been hypothesized that the observed impact on psycho-behavioural development of the offspring, might be partially explained by the psychosocial impact of a cancer diagnosis on the mother during pregnancy [ 14 , 18 , 19 ].…”

Long-term neurodevelopmental outcome after prenatal exposure to maternal hematological malignancies with or without cytotoxic treatment

“…The death of the mother is a major life event that potentially influences child development. Previous studies have shown an association between anxiety and stress during pregnancy with adverse birth outcomes (e.g., spontaneous abortion, preterm labor, growth restriction) and problems across several domains (cognitive, behavioral and emotional) in the child (Betchen et al, 2020;Van den Bergh et al, 2005). In subgroup analyses, receiving supportive care was associated with the death of the mother.…”

Long-Term Neurodevelopmental Outcome of Children after in Utero Exposure to Chemotherapy

“…However, various abnormalities were observed in child behavior and executive function after prenatal exposure to chemotherapy during the second and third trimester; weak emotional regulation, and high rates of internalizing, externalizing, and total behavior problems were observed. These findings may also be attributed to antenatal maternal stress, as several studies have demonstrated that maternal psychosocial functioning during pregnancy is highly associated with child cognition [37][38][39]. Thus, it is possible that child behavior and executive function are both influenced by the stress caused by cancer diagnosis during pregnancy.…”