Incidence and outcomes of pregnancy-associated melanoma in New South Wales 1994-2008.

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, 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-week gestation or 400 g 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 = 0.75 mm) than melanomas diagnosed postpartum (median = 0.60 mm) (P = 0.002). Pregnancy-associated melanoma was associated with the 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 three 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.

• Authors: Melanie Bannister-Tyrrell, Christine L Roberts, Csilla Hasovits, Tanya Nippita, Jane B Ford
• Journal: The Australian & New Zealand journal of obstetrics & gynaecology (Aust N Z J Obstet Gynaecol) Vol. 55 Issue 2 Pg. 116-22 (Apr 2015) ISSN: 1479-828X [Electronic] Australia
• PMID: 25349945 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Topics

• Adolescent
• Adult
• Birth Weight
• Cesarean Section (statistics & numerical data)
• Cohort Studies
• Female
• Humans
• Incidence
• Infant, Newborn
• Maternal Age
• Melanoma (epidemiology, pathology)
• Middle Aged
• New South Wales (epidemiology)
• Parity
• Postpartum Period
• Pregnancy
• Pregnancy Complications, Neoplastic (epidemiology, pathology)
• Skin Neoplasms (epidemiology, pathology)
• Stillbirth (epidemiology)
• Young Adult