Hyperemesis, gestational hypertensive disorders, pregnancy losses and risk of autoimmune diseases in a Danish population-based cohort

Jørgensen, Kristian Tore; Nielsen, Nete Munk; Pedersen, Bo Vest; Jacobsen, Søren; Frisch, Mørten

doi:10.1016/j.jaut.2011.10.002

Cited by 33 publications

(33 citation statements)

References 48 publications

(31 reference statements)

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“…For women age 60 and older, ANA prevalence increased steadily with age regardless of parity. Based on this inflection point and the possibility that different factors may influence ANA at different points in the lifespan, we ran separate models for younger (12–59) and older (60+) women to describe the relationship between age and ANA prevalence, with and without adjusting for parity (Figure 2). Results showed that parity completely attenuated the age-association in younger women ages (for each increasing decade versus ages 12–19, p for trend=0.019 before and p=0.998 after adjusting for parity).…”

Section: Resultsmentioning

confidence: 99%

Reproductive and Hormonal Risk Factors for Antinuclear Antibodies (ANA) in a Representative Sample of U.S. Women

Parks

Miller²,

Satoh

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Autoantibodies are of growing interest in cancer research as potential biomarkers; yet the determinants of autoimmunity are not well understood. Antinuclear antibodies (ANA) are common in the general population, and are more prevalent in women and older adults. Here we examined the relationship of ANA with reproductive and hormonal factors in a representative sample of U.S. women. Methods We analyzed data on reproductive history and exogenous hormone use in relation to serum ANA in 2,037 females ages 12 and older from the National Health and Nutrition Examination Survey (NHANES; 1999–2004). Estimated ANA prevalences were adjusted for sampling weights. Prevalence odds ratios (POR) and 95% confidence intervals (CI) were adjusted for age, race and poverty-income-ratio, and models were stratified by menopause status. Results In premenopausal women ages 20 and older, ANA prevalence was associated with parity (p<0.001; parous versus nulliparous POR=2.0; 95%CI 1.2, 3.4), but in parous women ANA did not vary by number of births, age at first birth, years since last birth or breastfeeding. In postmenopausal women, ANA prevalence was associated with an older age at menarche (p=0.019; age 16–20 versus 10–12 years POR=3.0, 95%CI 1.6, 5.9), but not with parity. Oral contraceptives and estrogen therapy were not associated with a higher ANA prevalence. Conclusions Childbearing (having had one or more births) may explain age-associated elevations in ANA prevalence seen in premenopausal women. Impact These findings highlight the importance of considering reproductive history in studies of autoimmunity and cancer in women.

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Section: Resultsmentioning

confidence: 99%

Reproductive and Hormonal Risk Factors for Antinuclear Antibodies (ANA) in a Representative Sample of U.S. Women

Parks

Miller²,

Satoh

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…A recent publication showed a skewed placental weight‐to‐birth weight ratio, possibly reflecting suboptimal placentation, but this was found only in women with HG who were carrying female fetuses 35. Moreover, HG is reported to be associated with subsequent increased risk of autoimmune diseases 23, 24. A Danish study found a statistically significant association between HG and autoimmune diseases in general and in particular between HG and Sjögren's syndrome, Graves’ disease, rheumatoid arthritis, pernicious anaemia, coeliac disease, Crohn's disease, ulcerative colitis and psoriasis 23.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, HG is reported to be associated with subsequent increased risk of autoimmune diseases 23, 24. A Danish study found a statistically significant association between HG and autoimmune diseases in general and in particular between HG and Sjögren's syndrome, Graves’ disease, rheumatoid arthritis, pernicious anaemia, coeliac disease, Crohn's disease, ulcerative colitis and psoriasis 23. Previous research has also found increased inflammatory markers in women with HG compared with healthy pregnancies 46, 47, 48, 49.…”

Section: Discussionmentioning

confidence: 99%

“…Although HG is the most common reason for hospitalisation during the first trimester,22 little is known about the long‐term consequences of HG exposure. Some studies have reported an association between HG and risk of autoimmune disease later in life 23, 24. A recent study investigating cancer risk after HG exposure reported an inverse association between HG and overall cancer risk 25.…”

Section: Introductionmentioning

confidence: 99%

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Hyperemesis gravidarum and long‐term mortality: a population‐based cohort study

Fossum

Vikanes

Næss

et al. 2016

BJOG

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ObjectiveTo investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long‐term mortality.DesignPopulation‐based cohort study.SettingMedical Birth Registry of Norway (1967–2002) linked to the Cause of Death Registry.PopulationWomen in Norway with singleton births in the period 1967–2002, with and without HG. Women were followed until 2009 or death.MethodsCox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI).Main outcome measuresThe primary outcome was all‐cause mortality during follow up. Secondary outcomes were cause‐specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders).ResultsOf 999 161 women with singleton births, 13 397 (1.3%) experienced HG. During a median follow up of 26 years (25 902 036 person‐years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long‐term all‐cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75–0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84–1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83–1.29), but a lower long‐term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75–0.98).ConclusionIn this large population‐based cohort study, HG was not associated with an increased risk of long‐term all‐cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer.Tweetable abstractPopulation‐based cohort study: Hyperemesis was not associated with an increased risk of long‐term mortality.

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“…Jørgensen et al33 demonstrated that the risk for any autoimmune disorder was significantly increased in women with HG (RR, 1.41; 95% CI, 1.30–1.51). In its extreme forms, HG may cause malnutrition and end organ damage manifesting as oliguria and abnormal liver function tests.…”

Section: Hg and Adverse Maternal Outcomesmentioning

confidence: 99%