{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:01:06Z","timestamp":1784718066126,"version":"3.55.0"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Autoimmune diseases disproportionately impact women and female-specific aspects of reproduction are thought to play a role. We investigated the time-varying association between pregnancy complications and new-onset autoimmune disease in females during the reproductive and midlife years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a population-based cohort study of 1\u00a0704\u00a0553 singleton births to 1\u00a0072\u00a0445 females in Ontario, Canada (2002\u201317) with no pre-existing autoimmune disease. Pregnancy complications were preeclampsia, stillbirth, spontaneous preterm birth and severe small for gestational age (SGA). Royston-Parmar models were used to estimate the time-varying association between pregnancy complications and a composite of 25 autoimmune diseases from date of delivery to date of autoimmune disease diagnosis or censoring at death, loss of health insurance, or 31 March 2021. Models were adjusted for baseline socio-demographics, parity and comorbidities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At 19\u2009years (median\u2009=\u200910.9\u2009years of follow-up), cumulative incidence of autoimmune disease was 3.1% in those with a pregnancy complication and 2.6% in those without complications. Adjusted hazard ratio (AHR) curves as a function of time since birth were generally L-shaped. Universally, risks were most elevated within the first 3\u2009years after birth [at 1\u2009year: preeclampsia AHR 1.22, 95% confidence interval (CI) 1.09\u20131.36; stillbirth AHR 1.36, 95% CI 0.99\u20131.85; spontaneous preterm birth AHR 1.30, 95% CI 1.18\u20131.44; severe SGA AHR 1.14, 95% CI 0.99\u20131.31] and plateaued but remained elevated thereafter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Prior history of pregnancy complications may be an important female-specific risk factor to consider during clinical assessment of females for possible autoimmune disease to facilitate timely detection and treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyae115","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T20:32:16Z","timestamp":1724790736000},"source":"Crossref","is-referenced-by-count":9,"title":["Pregnancy complications and new-onset maternal autoimmune disease"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5811-7661","authenticated-orcid":false,"given":"Natalie V","family":"Scime","sequence":"first","affiliation":[{"name":"Department of Health and Society, University of Toronto Scarborough , Toronto, Ontario, Canada"},{"name":"ICES , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-7854","authenticated-orcid":false,"given":"Sonia M","family":"Grandi","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel G","family":"Ray","sequence":"additional","affiliation":[{"name":"ICES , Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada"},{"name":"Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy-Lee","family":"Dennis","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital , Toronto, Ontario, Canada"},{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2205-2683","authenticated-orcid":false,"given":"Mary A","family":"De Vera","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia , Vancouver, British Columbia, Canada"},{"name":"Collaboration for Outcomes Research and Evaluation, University of British Columbia , Vancouver, British Columbia, Canada"},{"name":"Centre for Health Evaluation & Outcome Science, St. Paul\u2019s Hospital , Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6230-2245","authenticated-orcid":false,"given":"Hailey R","family":"Banack","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone N","family":"Vigod","sequence":"additional","affiliation":[{"name":"ICES , Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto , Toronto, Ontario, Canada"},{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Boblitz","sequence":"additional","affiliation":[{"name":"ICES , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8690-5841","authenticated-orcid":false,"given":"Hilary K","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Health and Society, University of Toronto Scarborough , Toronto, Ontario, Canada"},{"name":"ICES , Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, 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