‘Cancer in Pregnancy’: Effects of prenatal exposure to cancer treatment on IUGR. To examine the potential biomarkers to develop insights in the underlying pathophysiologic mechanisms of IUGR.

The current prevalence of cancer during pregnancy in Europe is 1 in 1000 to 2000 pregnancies, and this number is increasing. The primordial concern when treating cancer during pregnancy is the potential effect of chemo/radiotherapy on the fetal. In a recent pioneering study on 70 children with prenatal exposure to cancer treatment, Amant et al. found the developmental outcome of such children to be overall reassuring. However, intra-uterine growth restriction (IUGR), which places infants at significant risks of perinatal morbidity/mortality, was exceptionally frequent. The mechanism underlying IUGR following in utero exposure to cancer treatment is so far unexplored, hampering the identification of patients at risk and the development of preventive measures. This research proposal aims to address this lack of knowledge and proposes 1/ a large-scale observational patient study on the detailed epidemiology and prognosis of IUGR seen in pregnancies with maternal cancer treatment, 2/ a prospective patient study investigating the possible causes and pathophysiology of IUGR in these pregnancies, focusing specifically on biomarkers of placental function, and 3/ an experimental study exploring the effect of chemotherapeutics on placental trophoblast function in an vitro and in vivo model. Patient recruitment for the clinical studies is secured by an ongoing collaboration with the international task force