Adverse pregnancy outcomes and multiple cancers risk in both mother and offspring - an umbrella review of systematic reviews with meta-analyses of observational studies

Sep 21, 2026

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Adverse pregnancy outcomes are increasingly prevalent and carry serious health consequences, particularly regarding risks for multiple cancers in both mothers and their offspring. This umbrella review systematically evaluates the validity and strength of evidence and the extent of potential bias in the established associations between adverse pregnancy outcomes and cancer risk. Databases including PubMed, Embase, and Web of Science were searched through 18 January 2024, with certainty assessed using GRADE.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

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Abstract

Background

Methods

Results

Conclusions

Keywords

Liu et al. BMC Medicine (2024) 22:454 [https://doi.org/10.1186/s12916-024-03680-w](https://doi.org/10.1186/s12916-024-03680-w) BMC Medicine RESEARCH Open Access Adverse pregnancy outcomes and multiple cancers risk in both mother and offspring: an umbrella review of systematic reviews with meta-analyses of observational studies Na Liu4†, Rui-Han Bao 1,2,3†, Yu-Jiao Chang1,5†, Fang-Hua Liu 1,5†, Lang Wu6, Jia-Yi Wang3, Zi-Ping Niu3, Shuai Ma3, Yi-Xuan Men3, Ke-Xin Liu3, Dong-Hui Huang 1,5, Qian Xiao1,3, Song Gao3, Yue-Yang Zhao1,7*, Jian-Hua Fu4*, Qi-Jun Wu1,3,5,8* and Ting-Ting Gong3* Abstract Background Adverse pregnancy outcomes have reached epidemic proportions in recent years with serious health ramifications, especially for diverse cancers risk. Therefore, we carried out an umbrella review to systematically evaluate the validity and strength of the data and the extent of potential biases of the established association between adverse pregnancy outcomes and cancers risk in both mother and offspring. Methods PubMed, Embase, and Web of Science databases were searched from inception until 18 January 2024. Meta-analyses of observational studies investigating the relationship between adverse pregnancy outcomes and multiple cancers risk in both mother and offspring were included. Evidence certainty was assessed using Grading of Recommendations, Assessment, Development, and Evaluation. The protocol for this umbrella review was prospectively registered in PROSPERO (CRD42023470544) . Results The search identified 129 meta-analyses of observational studies and 42 types of cancer. Moderate certainty of evidence, exhibiting statistical significance, has been observed linking per kilogram increase in birth weight to a heightened risk of breast cancer (OR = 1 . 07, 95% CI = 1 .02–1. 12), prostate cancer (OR = 1 . 02, 95% CI = 1 .00–1. 05), leukemia (OR = 1 . 18, 95% CI = 1 .13–1. 23), and acute lymphoblastic leukemia in offspring (OR = 1 . 18, 95% CI = 1.12– 1. 23); rubella infection during pregnancy to an increased risk of leukemia in offspring (OR = 2 . 79, 95% CI = 1 .16–6. 71); and a linear dose–response association between an increase in the proportion of optimal birth weight and an elevated risk of acute lymphoblastic leukemia in offspring (OR = 1 . 16, 95% CI = 1 .09–1. 24), respectively. †Na Liu, Rui-Han Bao, Yu-Jiao Chang and Fang-Hua Liu contributed equally to this work. *Correspondence: Yue-Yang Zhao [zhaoyy@sj-hospital.org](zhaoyy@sj-hospital.org)[ ](zhaoyy@sj-hospital.org)Jian-Hua Fu [fujh@sj-hospital.org](fujh@sj-hospital.org)[ ](fujh@sj-hospital.org)Qi-Jun Wu [wuqj@sj-hospital.org](wuqj@sj-hospital.org)[ ](wuqj@sj-hospital.org)Ting-Ting Gong [gongtt@sj-hospital.org](gongtt@sj-hospital.org) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/.)[.](http://creativecommons.org/licenses/by-nc-nd/4.0/.)

FAQs

What is the purpose of this umbrella review?

To systematically evaluate the validity, strength, and potential bias of evidence linking adverse pregnancy outcomes with multiple cancer risks in both mothers and offspring.

Which databases were searched, and what is the cutoff date?

PubMed, Embase, and Web of Science were searched from inception through 18 January 2024.

What associations did the review report between birth weight and cancer risk?

A per-kilogram increase in birth weight showed moderate-certainty evidence of higher breast cancer, prostate cancer, leukemia, and acute lymphoblastic leukemia risk in offspring, with reported odds ratios and confidence intervals.

Sep 21, 2026

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