Meta-Analysis: Are Adverse Pregnancy Outcomes Associated with Hodgkin Lymphoma?
BACKGROUND AND PURPOSE:
Houlihan et al. (BJOG, 2022) synthesized the published literature on the relationship between Hodgkin lymphoma (HL) and maternal and perinatal outcomes
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
Where data permitted, meta-analyses of odds ratios (OR) and proportions were performed
Certainty of evidence was determined using GRADE criteria
Certainty of evidence ranged from very low to low
HL before or during pregnancy vs controls was not associated with increased risk for
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)
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)
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)
HL during pregnancy: 69% (95% CI, 57 to 80)
Control: 4% (95% CI, 4 to 5)
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
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