Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study

BACKGROUND: The loss of one or more pregnancies before viability (i.e. pregnancy loss or miscarriage), has been linked to an increased risk of diseases later in life such as myocardial infarction and stroke. Recurrent pregnancy loss (i.e. three consecutive pregnancy losses) and multiple sclerosis ha...

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Autores principales: Mikkelsen, Anders Pretzmann, Egerup, Pia, Kolte, Astrid Marie, Westergaard, David, Nielsen, Henriette Svarre, Lidegaard, Øjvind
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970484/
https://www.ncbi.nlm.nih.gov/pubmed/35358256
http://dx.doi.org/10.1371/journal.pone.0266203
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author Mikkelsen, Anders Pretzmann
Egerup, Pia
Kolte, Astrid Marie
Westergaard, David
Nielsen, Henriette Svarre
Lidegaard, Øjvind
author_facet Mikkelsen, Anders Pretzmann
Egerup, Pia
Kolte, Astrid Marie
Westergaard, David
Nielsen, Henriette Svarre
Lidegaard, Øjvind
author_sort Mikkelsen, Anders Pretzmann
collection PubMed
description BACKGROUND: The loss of one or more pregnancies before viability (i.e. pregnancy loss or miscarriage), has been linked to an increased risk of diseases later in life such as myocardial infarction and stroke. Recurrent pregnancy loss (i.e. three consecutive pregnancy losses) and multiple sclerosis have both been linked to immunological traits, which could predispose to both occurrences. The objective of the current study was to investigate if pregnancy loss is associated with later autoimmune neurological disease. METHODS: This register-based cohort study, included the Danish female population age 12 or older between 1977–2017. Women were grouped hierarchically: 0, 1, 2, ≥3 pregnancy losses, primary recurrent pregnancy loss (i.e. not preceded by a delivery), and secondary recurrent pregnancy loss (i.e. preceded by a delivery). The main outcome was multiple sclerosis and additional outcomes were amyotrophic lateral sclerosis, Guillain-Barré syndrome, and myasthenia gravis. Bayesian Poisson regression estimated incidence rate ratios [IRR] and 95% credible intervals [CI] adjusted for year, age, live births, family history of an outcome, and education. RESULTS: After 40,380,194 years of follow-up, multiple sclerosis was diagnosed among 7,667 out of 1,513,544 included women (0.5%), median age at diagnosis 34.2 years (IQR 27.4–41.4 years), and median age at symptom onset 31.2 years (IQR 24.8–38.2). The adjusted IRR of multiple sclerosis after 1 pregnancy loss was: 1.03 (95% CI 0.95–1.11), 2 losses: 1.02 (95% CI 0.86–1.20), ≥3 non-consecutive losses: 0.81 (95% CI 0.51–1.24), primary recurrent pregnancy loss: 1.18 (95% CI 0.84–1.60), secondary recurrent pregnancy loss: 1.16 (95% CI 0.81–1.63), as compared to women with no pregnancy losses. Seven sensitivity analyses and analyses for additional outcomes did not show significantly elevated adjusted risk estimates. CONCLUSIONS: In this nationwide study, pregnancy loss was not significantly associated with autoimmune neurological disorder.
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spelling pubmed-89704842022-04-01 Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study Mikkelsen, Anders Pretzmann Egerup, Pia Kolte, Astrid Marie Westergaard, David Nielsen, Henriette Svarre Lidegaard, Øjvind PLoS One Research Article BACKGROUND: The loss of one or more pregnancies before viability (i.e. pregnancy loss or miscarriage), has been linked to an increased risk of diseases later in life such as myocardial infarction and stroke. Recurrent pregnancy loss (i.e. three consecutive pregnancy losses) and multiple sclerosis have both been linked to immunological traits, which could predispose to both occurrences. The objective of the current study was to investigate if pregnancy loss is associated with later autoimmune neurological disease. METHODS: This register-based cohort study, included the Danish female population age 12 or older between 1977–2017. Women were grouped hierarchically: 0, 1, 2, ≥3 pregnancy losses, primary recurrent pregnancy loss (i.e. not preceded by a delivery), and secondary recurrent pregnancy loss (i.e. preceded by a delivery). The main outcome was multiple sclerosis and additional outcomes were amyotrophic lateral sclerosis, Guillain-Barré syndrome, and myasthenia gravis. Bayesian Poisson regression estimated incidence rate ratios [IRR] and 95% credible intervals [CI] adjusted for year, age, live births, family history of an outcome, and education. RESULTS: After 40,380,194 years of follow-up, multiple sclerosis was diagnosed among 7,667 out of 1,513,544 included women (0.5%), median age at diagnosis 34.2 years (IQR 27.4–41.4 years), and median age at symptom onset 31.2 years (IQR 24.8–38.2). The adjusted IRR of multiple sclerosis after 1 pregnancy loss was: 1.03 (95% CI 0.95–1.11), 2 losses: 1.02 (95% CI 0.86–1.20), ≥3 non-consecutive losses: 0.81 (95% CI 0.51–1.24), primary recurrent pregnancy loss: 1.18 (95% CI 0.84–1.60), secondary recurrent pregnancy loss: 1.16 (95% CI 0.81–1.63), as compared to women with no pregnancy losses. Seven sensitivity analyses and analyses for additional outcomes did not show significantly elevated adjusted risk estimates. CONCLUSIONS: In this nationwide study, pregnancy loss was not significantly associated with autoimmune neurological disorder. Public Library of Science 2022-03-31 /pmc/articles/PMC8970484/ /pubmed/35358256 http://dx.doi.org/10.1371/journal.pone.0266203 Text en © 2022 Mikkelsen et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Mikkelsen, Anders Pretzmann
Egerup, Pia
Kolte, Astrid Marie
Westergaard, David
Nielsen, Henriette Svarre
Lidegaard, Øjvind
Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study
title Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study
title_full Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study
title_fullStr Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study
title_full_unstemmed Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study
title_short Pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: A nationwide cohort study
title_sort pregnancy loss and risk of multiple sclerosis and autoimmune neurological disorder: a nationwide cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970484/
https://www.ncbi.nlm.nih.gov/pubmed/35358256
http://dx.doi.org/10.1371/journal.pone.0266203
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