gms | German Medical Science

Objective: Optimization of the management of brain tumors (BT) has led to an improvement of prognosis. Thus, young women bearing BT often raise the question of whether or not becoming a child is harmful.

Methods: We retrospectively evaluated data of all pregnant patients (pat.) in our prospectively collected database of brain tumor patients.

Results: 26 pregnancies occurred in 19 pat. harboring BT. Of these, 8 suffered from a high-grade glioma while 11 had a low-grade glioma. 23 pregnancies were fully carried out. BT was diagnosed in 8 patients during pregnancy. One patient with a subependymoma suffering a missed abortion is recurrence-free, another with ganglioglioma grade II did not show progression until now, one pat. with oligoastrocytoma (OA) II is stable under treatment. Two patients with glioma grade III died 6 weeks and 46 months after pregnancy, another with grade III glioma was progressive 133 months after pregnancy. One pat. with OA III is stable since pregnancy (81 months) another with glioblastoma (GBM) is stable 54 months after pregnancy In the other 11 pat. pregnancy occurred during the course of the disease. Progressive disease was observed in three pat.: one pat. 12 months after operation of an oligodendroglioma grade II (ODG II), one pat. 56 months after operation of an anaplastic OA and one pat. was pregnant 21 months after operation of a GBM. She died 7 months later. One patient got pregnant another 3 times despite ongoing malignisation of her OA II and died 2 weeks after cesarian of her fourth child. The other 9 are still living with stable disease 3 to 245 months after pregnancy.

Conclusions: BT per se should not prohibit pregnancy, since a negative influence on the course of the disease is not the rule. There is no proof that pregnancy is associated with tumor progression or recurrence. However, patients should be informed that tumor progression during pregnancy might occur. Especially in malignant gliomas the benefit-to-risk ratio should be carefully weighed. Further research regarding pregnancy related growth factor interactions with BT is warranted.