BACKGROUND AND PURPOSE:

• Houlihan et al. (BJOG, 2022) synthesized the published literature on the relationship between Hodgkin lymphoma (HL) and maternal and perinatal outcomes

METHODS:

• Systematic review and meta-analysis
• Study inclusion criteria
  • Reported original data
  • Compared a previous or current diagnosis of HL to no previous or current HL and reported pregnancy or neonatal outcomes
• Study design
  • Where data permitted, meta-analyses of odds ratios (OR) and proportions were performed
  • Certainty of evidence was determined using GRADE criteria
• Primary outcomes
  • Congenital malformations
  • Preterm birth
  • Miscarriage

RESULTS:

• 33 studies
• Certainty of evidence ranged from very low to low

HL before or during pregnancy vs controls was not associated with increased risk for

• Congenital malformations
  • HL before pregnancy: aOR 1.7 (95% CI, 0.9 to 3.1)
  • HL during pregnancy: aOR 1.84 (95% CI, 0.81 to 4.15)
• Preterm birth
  • HL before pregnancy: aOR 0.99 (95% CI, 0.65 to 1.51)
  • HL during pregnancy: aOR 6.74 (95% CI, 0.52 to 88.03)
• Miscarriage
  • HL before pregnancy: aOR 0.78 (95% CI, 0.55 to 1.10)
  • HL during pregnancy: aOR 0.38 (95% CI, 0.05 to 2.72)

HL diagnosed during pregnancy was associated with increased risk for

• Blood transfusion: aOR 1.38 (95% CI, 1.05 to 1.82)
• Venous thromboembolism: aOR 7.93 (95% CI, 2.97 to 21.22)
• Anemia
  • HL during pregnancy: 69% (95% CI, 57 to 80)
  • Control: 4% (95% CI, 4 to 5)

CONCLUSION:

• Compared to the general pregnant population, individuals with HL diagnosed before or during pregnancy, do not appear to be at increased risk for congenital malformations, preterm birth, or miscarriage
• Women with HL during pregnancy may experience more venous thromboembolism, anemia, and require more blood transfusions
• The authors state

Future primary research should be based on large cohorts of pregnant women with a current or previous diagnosis of HL and should stratify the outcome data by timing and treatment received, parity, race, and ethnicity

Data should also be reported separately for elective and emergency CS and planned and spontaneous PTB to further inform management decisions during pregnancy

Learn More – Primary Sources:

Maternal and perinatal outcomes following a diagnosis of Hodgkin lymphoma during or prior to pregnancy: a systematic review

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