Pregnancy and the risk of autoimmune disease.

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...

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Autores principales:	Ali S Khashan, Louise C Kenny, Thomas M Laursen, Uzma Mahmood, Preben B Mortensen, Tine B Henriksen, Keelin O'Donoghue
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/439b446f4f1d4861857e32fe5d743e0f
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spelling	oai:doaj.org-article:439b446f4f1d4861857e32fe5d743e0f2021-11-18T06:53:49ZPregnancy and the risk of autoimmune disease.1932-620310.1371/journal.pone.0019658https://doaj.org/article/439b446f4f1d4861857e32fe5d743e0f2011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21611120/?tool=EBIhttps://doaj.org/toc/1932-6203Autoimmune 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.Ali S KhashanLouise C KennyThomas M LaursenUzma MahmoodPreben B MortensenTine B HenriksenKeelin O'DonoghuePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 5, p e19658 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ali S Khashan Louise C Kenny Thomas M Laursen Uzma Mahmood Preben B Mortensen Tine B Henriksen Keelin O'Donoghue Pregnancy and the risk of autoimmune disease.
description	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.
format	article
author	Ali S Khashan Louise C Kenny Thomas M Laursen Uzma Mahmood Preben B Mortensen Tine B Henriksen Keelin O'Donoghue
author_facet	Ali S Khashan Louise C Kenny Thomas M Laursen Uzma Mahmood Preben B Mortensen Tine B Henriksen Keelin O'Donoghue
author_sort	Ali S Khashan
title	Pregnancy and the risk of autoimmune disease.
title_short	Pregnancy and the risk of autoimmune disease.
title_full	Pregnancy and the risk of autoimmune disease.
title_fullStr	Pregnancy and the risk of autoimmune disease.
title_full_unstemmed	Pregnancy and the risk of autoimmune disease.
title_sort	pregnancy and the risk of autoimmune disease.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/439b446f4f1d4861857e32fe5d743e0f
work_keys_str_mv	AT aliskhashan pregnancyandtheriskofautoimmunedisease AT louiseckenny pregnancyandtheriskofautoimmunedisease AT thomasmlaursen pregnancyandtheriskofautoimmunedisease AT uzmamahmood pregnancyandtheriskofautoimmunedisease AT prebenbmortensen pregnancyandtheriskofautoimmunedisease AT tinebhenriksen pregnancyandtheriskofautoimmunedisease AT keelinodonoghue pregnancyandtheriskofautoimmunedisease
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Pregnancy and the risk of autoimmune disease.

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