Authors
Khashan, Ali SKenny, 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.Issue Date
2012-01-31T16:42:57ZMeSH
AdolescentAdult
Autoimmune Diseases/classification/*epidemiology
Denmark/epidemiology
Female
Follow-Up Studies
Humans
Male
Pregnancy
Risk Factors
Young Adult
Metadata
Show full item recordCitation
PLoS One. 2011;6(5):e19658. Epub 2011 May 18.Journal
PloS oneDOI
10.1371/journal.pone.0019658PubMed ID
21611120Abstract
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
engISSN
1932-6203 (Electronic)1932-6203 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1371/journal.pone.0019658
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