Adverse Birth and Obstetric Outcomes in the Offspring of Male Adolescent and Young Adult Cancer Survivors: A Nationwide Population-Based Study

BACKGROUND: The growing population of male adolescent and young adult (AYA, ages 15-40 years) cancer survivors has heightened interest in their reproductive health. However, studies have reported conflicting findings on the potential risks of cancer and its treatments on birth and obstetric outcomes. METHODS: We used encrypted identification numbers for both fathers and mothers to link three nationwide Taiwan datasets from 2004 to 2019, identifying 3,785 births with a paternal history of AYA cancer. For comparison, we included 37,850 matched fathers without a cancer history, matched by paternal age and infant birth year. We used multivariable logistic regression analysis to identify independent associations between adverse birth outcomes (e.g., preterm labor, low birthweight, and congenital malformations) and obstetric outcomes (e.g., fetal growth restriction, threatened labor, and threatened abortion) and being born to male AYA cancer survivors. RESULTS: The offspring of male AYA cancer survivors did not exhibit a significantly increased risk of adverse birth (OR = 1.0; 95% confidence interval, 0.9-1.1) or obstetric (OR = 1.1; 95% confidence interval, 1.0-1.1) outcomes compared with offspring born to cancer-free matched fathers. Furthermore, the risk of preterm labor, low birthweight, congenital malformations, fetal growth restriction, and threatened labor or miscarriage was comparable between groups. CONCLUSIONS: Paternal cancer history during adolescence or young adulthood does not seem to increase the risk of adverse birth or obstetric outcomes in offspring. IMPACT: This study reassures the reproductive health of this population, providing valuable insights for oncology and reproductive medicine, potentially influencing patient counseling and guidelines.