Long-term impact of prenatal exposure to chemotherapy on executive functioning: an ERP study

Abstract Objective This study examines the long-term impact of prenatal exposure to chemotherapy on executive functioning and the contribution of late-prematurity to this effect, using event-related potentials. Methods Mothers of the prenatal-exposed children (n=20) were diagnosed with cancer and received chemotherapeutic treatment during pregnancy. We recruited healthy controls (n=20) who were matched on a 1:1 ratio regarding prematurity, age and sex. We assessed executive functioning at the age of nine, using two event-related potential paradigms: a Go/Nogo paradigm to investigate processes of response inhibition and conflict monitoring, as well as a Posner paradigm to investigate spatial attention. Results Lower potentials were found in prenatal-exposed children compared to controls in the Go/Nogo P3 and Posner positive slow wave. Moreover, prenatal-exposed children responded slower on the Posner paradigm compared to controls ( p , with more incorrect responses ( p=.023) . In the control group, the N2 Go/Nogo wave was more pronounced in children born after a longer gestation. Conclusions This is the first study that demonstrates an effect of prenatal exposure to chemotherapy on the development of executive functioning, not limited to the effect of late-prematurity. Significance This study emphasizes the necessity of a long-term follow-up of prenatal-exposed children to re-inform clinical practice on the costs and benefits of late-premature induction over treatment during pregnancy.