Hdl Handle:
http://hdl.handle.net/10147/206243
Title:
Pregnancy and the risk of autoimmune disease.
Authors:
Khashan, Ali S; Kenny, Louise C; Laursen, Thomas M; Mahmood, Uzma; Mortensen, Preben B; Henriksen, Tine B; O'Donoghue, Keelin
Affiliation:
Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University, Maternity Hospital, University College Cork, Wilton, Cork, Republic of Ireland.
Citation:
PLoS One. 2011;6(5):e19658. Epub 2011 May 18.
Journal:
PloS one
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206243
DOI:
10.1371/journal.pone.0019658
PubMed ID:
21611120
Abstract:
Autoimmune diseases (AID) predominantly affect women of reproductive age. While basic molecular studies have implicated persisting fetal cells in the mother in some AID, supportive epidemiological evidence is limited. We investigated the effect of vaginal delivery, caesarean section (CS) and induced abortion on the risk of subsequent maternal AID. Using the Danish Civil Registration System (CRS) we identified women who were born between 1960 and 1992. We performed data linkage between the CRS other Danish national registers to identify women who had a pregnancy and those who developed AID. Women were categorised into 4 groups; nulligravida (control group), women who had 1st child by vaginal delivery, whose 1st delivery was by CS and who had abortions. Log-linear Poisson regression with person-years was used for data analysis adjusting for several potential confounders. There were 1,035,639 women aged >14 years and 25,570 developed AID: 43.4% nulligravida, 44.3% had their first pregnancy delivered vaginally, 7.6% CS and 4.1% abortions. The risk of AID was significantly higher in the 1st year after vaginal delivery (RR = 1.1[1.0, 1.2]) and CS (RR = 1.3[1.1, 1.5]) but significantly lower in the 1st year following abortion (RR = 0.7[0.6, 0.9]). These results suggest an association between pregnancy and the risk of subsequent maternal AID. Increased risks of AID after CS may be explained by amplified fetal cell traffic at delivery, while decreased risks after abortion may be due to the transfer of more primitive fetal stem cells. The increased risk of AID in the first year after delivery may also be related to greater testing during pregnancy.
Language:
eng
MeSH:
Adolescent; Adult; Autoimmune Diseases/classification/*epidemiology; Denmark/epidemiology; Female; Follow-Up Studies; Humans; Male; Pregnancy; Risk Factors; Young Adult
ISSN:
1932-6203 (Electronic); 1932-6203 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKhashan, Ali Sen_GB
dc.contributor.authorKenny, Louise Cen_GB
dc.contributor.authorLaursen, Thomas Men_GB
dc.contributor.authorMahmood, Uzmaen_GB
dc.contributor.authorMortensen, Preben Ben_GB
dc.contributor.authorHenriksen, Tine Ben_GB
dc.contributor.authorO'Donoghue, Keelinen_GB
dc.date.accessioned2012-01-31T16:42:57Z-
dc.date.available2012-01-31T16:42:57Z-
dc.date.issued2012-01-31T16:42:57Z-
dc.identifier.citationPLoS One. 2011;6(5):e19658. Epub 2011 May 18.en_GB
dc.identifier.issn1932-6203 (Electronic)en_GB
dc.identifier.issn1932-6203 (Linking)en_GB
dc.identifier.pmid21611120en_GB
dc.identifier.doi10.1371/journal.pone.0019658en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206243-
dc.description.abstractAutoimmune diseases (AID) predominantly affect women of reproductive age. While basic molecular studies have implicated persisting fetal cells in the mother in some AID, supportive epidemiological evidence is limited. We investigated the effect of vaginal delivery, caesarean section (CS) and induced abortion on the risk of subsequent maternal AID. Using the Danish Civil Registration System (CRS) we identified women who were born between 1960 and 1992. We performed data linkage between the CRS other Danish national registers to identify women who had a pregnancy and those who developed AID. Women were categorised into 4 groups; nulligravida (control group), women who had 1st child by vaginal delivery, whose 1st delivery was by CS and who had abortions. Log-linear Poisson regression with person-years was used for data analysis adjusting for several potential confounders. There were 1,035,639 women aged >14 years and 25,570 developed AID: 43.4% nulligravida, 44.3% had their first pregnancy delivered vaginally, 7.6% CS and 4.1% abortions. The risk of AID was significantly higher in the 1st year after vaginal delivery (RR = 1.1[1.0, 1.2]) and CS (RR = 1.3[1.1, 1.5]) but significantly lower in the 1st year following abortion (RR = 0.7[0.6, 0.9]). These results suggest an association between pregnancy and the risk of subsequent maternal AID. Increased risks of AID after CS may be explained by amplified fetal cell traffic at delivery, while decreased risks after abortion may be due to the transfer of more primitive fetal stem cells. The increased risk of AID in the first year after delivery may also be related to greater testing during pregnancy.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAutoimmune Diseases/classification/*epidemiologyen_GB
dc.subject.meshDenmark/epidemiologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshYoung Adulten_GB
dc.titlePregnancy and the risk of autoimmune disease.en_GB
dc.contributor.departmentAnu Research Centre, Department of Obstetrics and Gynaecology, Cork University, Maternity Hospital, University College Cork, Wilton, Cork, Republic of Ireland.en_GB
dc.identifier.journalPloS oneen_GB
dc.description.provinceMunster-

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