Objective: Determine the effects of cancer treatment in pregnancy. Design: Observational retrospective cohort study. Setting: 7 Chinese tertiary A hospitals during 2003–2021. Population: Pregnant patients with cancer. Methods: We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and chi-square tests to explore the effects of cancer type/treatment. Main outcome measures: Obstetric outcomes; Neonatal outcomes. Results: Of 204 women, 17% terminated pregnancies; 59% received pre-delivery treatment. Rates of pregnancy termination ([RR]: 0.48, 95% confidence interval [CI]: 0.35–0.67) and iatrogenic preterm births (RR: 0.73, 95% CI: 0.54–0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR: 1.87, 95% CI: 1.31–2.67). Maternal systemic diseases were related to a higher risk of small-for-gestational-age infants ([OR]: 12.02, 95% CI: 1.82–79.43). Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR: 1.87, 95% CI: 1.42–2.46, P < 0.05). Thyroid (OR: 0.36, 95% CI: 0.22–0.57) and ovarian cancer (OR: 0.70, 95% CI: 0.50–0.98) were associated with fewer cesarean sections. Thyroid cancer was associated with fetal growth restriction (OR: 5.21, 95% CI: 1.21–22.55). Conclusions: Rates of pregnancy termination in cancer have declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes. Funding: Special Project for clinical Research in health industry of Shanghai Municipal Health Commission; Shanghai Science and Technology Commission. Tweetable abstract: Cancer in pregnancy on obstetric and neonatal outcomes: higher risks of adverse obstetric and neonatal outcomes.

Objective: Infertility is a complex disease, which has a significant impact on medicine, social psychology and economy. There is no unified conclusion on the choice of drug treatment. Our goal is to investigate the actual drug treatment mode of reproductive assistance patients in China, focusing on the trend and rationality of sex hormone use in the past five years. Method：We conducted a cross-sectional analysis of the data from the hospital prescription analysis cooperation project supervised by the China Medical Association during 2016 to 2020. Results: Among the 225225 patients included in this study, the top three cities were Guangzhou, Shanghai and Zhengzhou. In five years, the average age is 32.99 years old. There were 11 kinds of main therapeutic drugs used. The top five were urotropin for injection, different progesterone preparations, chorionic gondotrophin for injection, dydrogesterone and triptorelin for injection. Although the total dosage of urotropin was the highest, it showed a downward trend. The dosage of progesterone and didroxyprogesterone showed an upward trend, among which progesterone showed the fastest upward trend. Conclusion: The average age of patients has not increased significantly, while the opportunity cost of women’s childbirth has increased, which seriously hinders the realization of childbearing intention. The overall medication selection is reasonable. The dosage of first-line urotropin and chorionic gonadotropin recommended by the guidelines is also high in this study, but the dosage of oral first-line treatment of ovarian stimulation in unexplained infertility is low, and the dosage of progesterone is gradually increasing.