Incidence and outcomes of pregnancy‐associated melanoma in New South Wales
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Open Access
Type
ArticleAuthor/s
Bannister-Tyrrell, MelanieRoberts, Christine L.
Hasovits, Csilla
Nippita, Tanya
Ford, Jane B.
Abstract
Background: There is controversy about the interaction between melanoma and pregnancy. There is a lack of Australian data on pregnancy outcomes associated with melanoma in pregnancy, despite Australia having the highest incidence of melanoma in the world. Aims: Describe trends, ...
See moreBackground: There is controversy about the interaction between melanoma and pregnancy. There is a lack of Australian data on pregnancy outcomes associated with melanoma in pregnancy, despite Australia having the highest incidence of melanoma in the world. Aims: Describe trends, maternal characteristics and pregnancy outcomes associated with pregnancy‐associated melanoma in New South Wales Materials and Methods: Population‐based cohort study of all births (n=1,309,501) of at least 20 weeks gestation or 400g birthweight in New South Wales, 1994‐2008. Logistic regression was used to analyse the association between melanoma in pregnancy and adverse birth outcomes. Results: 577 pregnancy‐associated melanomas were identified, including 195 diagnosed during pregnancy and 382 diagnosed within 12 months postpartum. The crude incidence of pregnancy‐associated melanoma increased from 37.1 per 100,000 maternities in 1994 to 51.84 per 100,000 maternities in 2008. Adjusting for maternal age accounted for the trend in pregnancy‐associated melanoma. Melanomas diagnosed in pregnancy were thicker (median=0.75mm) than melanomas diagnosed postpartum (median=0.60mm) (p=0.002). Pregnancy‐associated melanoma was associated with increased risk of large for gestational age infant but not preterm birth, planned birth, caesarean section or stillbirth. Parity was inversely associated with pregnancy‐associated melanoma, as women with 3 or more previous pregnancies had 0.59 times the odds of pregnancy‐associated melanoma compared to nulliparous women (95% CI 0.42‐0.84, p=0.003). Conclusions: The incidence of pregnancy‐associated melanoma has increased with increasing maternal age. The observation of thicker melanomas in pregnancy and increased risk of large for gestational age infants may suggest a role for growth‐related pregnancy factors in pregnancy‐associated melanoma.
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See moreBackground: There is controversy about the interaction between melanoma and pregnancy. There is a lack of Australian data on pregnancy outcomes associated with melanoma in pregnancy, despite Australia having the highest incidence of melanoma in the world. Aims: Describe trends, maternal characteristics and pregnancy outcomes associated with pregnancy‐associated melanoma in New South Wales Materials and Methods: Population‐based cohort study of all births (n=1,309,501) of at least 20 weeks gestation or 400g birthweight in New South Wales, 1994‐2008. Logistic regression was used to analyse the association between melanoma in pregnancy and adverse birth outcomes. Results: 577 pregnancy‐associated melanomas were identified, including 195 diagnosed during pregnancy and 382 diagnosed within 12 months postpartum. The crude incidence of pregnancy‐associated melanoma increased from 37.1 per 100,000 maternities in 1994 to 51.84 per 100,000 maternities in 2008. Adjusting for maternal age accounted for the trend in pregnancy‐associated melanoma. Melanomas diagnosed in pregnancy were thicker (median=0.75mm) than melanomas diagnosed postpartum (median=0.60mm) (p=0.002). Pregnancy‐associated melanoma was associated with increased risk of large for gestational age infant but not preterm birth, planned birth, caesarean section or stillbirth. Parity was inversely associated with pregnancy‐associated melanoma, as women with 3 or more previous pregnancies had 0.59 times the odds of pregnancy‐associated melanoma compared to nulliparous women (95% CI 0.42‐0.84, p=0.003). Conclusions: The incidence of pregnancy‐associated melanoma has increased with increasing maternal age. The observation of thicker melanomas in pregnancy and increased risk of large for gestational age infants may suggest a role for growth‐related pregnancy factors in pregnancy‐associated melanoma.
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Date
2015-01-01Publisher
Australian and New Zealand Journal of Obstetrics and GynaecologyDepartment, Discipline or Centre
Kolling Institute of Medical Research, University of Sydney, NSW AustraliaCitation
This manuscript has been published in the Australian and New Zealand Journal of Obstetrics and Gynaecology with the following citation: Bannister‐Tyrell M, Roberts CL, Hasovits C, Nippita T, Ford JB. Incidence and outcomes of pregnancy‐associated melanoma in New South Wales, 1994‐2008. ANZJOG 2015; 55(2): 116‐122. DOI: 10.1111/ajo.12279Share