Natural history of molar pregnancy in adolescents: a study in North and South America

Abstract

Although adolescents comprise 30% of all cases of hydatidiform mole, the influence of young age on the risk of GTN development after a molar pregnancy is still to be determined. Objectives: To assess complete hydatidiform mole (CHM) clinical characteristics and the riskfactors associated with the development of post-molar GTN in teenagers from North and SouthAmerica. Methods: Non-concurrent cohort study including patients with CHM evaluated at reference centerslocated in Botucatu (São Paulo State University-Unesp, Brazil), Niterói (Universidade Federal Fluminense, Brazil), Caracas (Central University of Venezuela), and Boston (New England Trophoblastic Disease Center, Harvard University, USA), between 1990 and 2011. Patient clinical data including age, gestational age at diagnosis, uterine size, pre-evacuation serum hCG, presence of theca lutein cysts, anemia, vaginal bleeding, gestational hypertension/preeclampsia, hyperemesis and respiratory insufficiency will be extracted from medical records and databases. Study participants will be allocated into two groups: adolescents (< 20 years); and adults (20-39 years). Post-CHM GTN will be diagnosed according to FIGO 2002 criteria. Logistic regression will be used to estimate the odds ratio (OR) and 95% confidence intervals (CI) for the risk of malignancy in the different age groups. Significance level will be set at p < 0.05. (AU)