Oncological Care in Pregnant Populations

Oncological care in pregnant populations requires a careful balance between optimising maternal outcomes and safeguarding fetal health. Cancer during pregnancy is rare but increasingly recognised due to delayed childbearing and improved diagnostic methods. Management encompasses accurate diagnosis—often adapted to minimise fetal exposure to ionising radiation—followed by multidisciplinary planning that integrates obstetric, oncological, surgical and neonatal expertise. Treatment adaptations depend on gestational age: surgery can be safely performed in all trimesters with obstetric support; most chemotherapy regimens are feasible after the first trimester; targeted agents and radiotherapy are generally deferred until after delivery. Delivery planning must consider cancer type, treatment status and obstetric indications, with timing tailored to allow maternal therapy to continue postpartum. Long-term follow-up of children exposed in utero is an emerging priority, addressing neurodevelopment, cardiac function and potential late effects. Global registries and tumour boards foster evidence-based protocols and psychosocial support, while ongoing research seeks to refine risk stratification, optimise drug dosing and clarify the impact of pregnancy-associated tissue changes on tumour biology.

Research from Nature Portfolio

Recent genomic analyses of the healthy parous breast have provided a reference map of somatic mutations acquired during reproductive years. This work reveals that both epithelial and stromal compartments accumulate driver mutations with age, and that parity influences the size and selection of mutated clones. In older first-time mothers, expanded clones in the mammary epithelium suggest a higher probability of oncogenic events, offering a mechanistic link between age at pregnancy and breast cancer risk. These findings underline the importance of integrating genomic risk assessment into surveillance strategies for pregnant and postpartum women, and may inform personalised approaches to early detection and prevention.

Oncological Care in Pregnant Populations publication trend

The graph below shows the total number of articles in oncological care in pregnant populations across all publications each year (not limited to Nature Index journals).

Technical terms

Gestational age: Duration of pregnancy measured in weeks from the last menstrual period.

Chemotherapy: Use of cytotoxic drugs to destroy or inhibit cancer cell growth.

Multidisciplinary team: Group of specialists (e.g., oncologists, obstetricians, surgeons, neonatologists) collaborating on patient management.

Parity: Number of times a woman has given birth to a viable offspring, influencing breast tissue biology and cancer risk.

Placental transfer: Movement of substances, including drugs, across the placenta from mother to fetus.

References

1. The mutational landscape of the adult healthy parous and nulliparous human breast. Nature Communications (2023).
2. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Annals of Oncology (2019).
3. Pregnancy and Cancer: the INCIP Project. Current Oncology Reports (2020).
4. Management of pregnancy in women with cancer. International Journal of Gynecological Cancer (2021).