Conclusion
In the U.S., maternal morbidity and mortality is increasing, and there is a need to target populations at higher risks. Taken together, our findings suggest that tackling adverse perinatal outcomes in AYA cancer survivors involves mitigating pre- and intra-pregnancy comorbidities this population experiences as a result of cancer and related treatment. Our findings are clinically significant, because they inform counseling, screening, and medical management to prevent and manage both comorbidities as well as the adverse perinatal outcomes of preterm birth and severe maternal morbidity. Next, detailing which specific cancer treatments, beyond broad categories of chemotherapy, radiation, and surgery, are related to which maternal comorbidity is needed to prioritize research and clinical screening and surveillance. Future studies that leverage claims data to measure more detailed exposures may be feasible and valid.48-50