{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T07:52:38Z","timestamp":1750405958812,"version":"3.40.5"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T00:00:00Z","timestamp":1691971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vaginal bleeding (VB) before 20 gestational weeks of a viable pregnancy is a manifestation of a threatened miscarriage. VB is associated with increased levels of pro\u2010inflammatory cytokines such as interferon\u2010gamma, tumour necrosis factor\u2010alpha and interleukin\u20106. Increased levels of these cytokines and oxidative stress are risk factors for cancer. The risk of cancer following a VB\u2010affected pregnancy that ended in childbirth is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the associations between VB in pregnancy that resulted in delivery and risk of incident cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cohort study (1995\u20132018) in Denmark using administrative and healthcare registries. We included 37,082 VB\u2010affected deliveries, 1,363,614 VB\u2010unaffected deliveries, 324,328 pregnancies ending in terminations, and 137,104 miscarriages. We computed the absolute risk of cancer and hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, calendar year, morbidities, and socio\u2010economic factors using Cox proportional hazards regression. Multiple pregnancies to the same woman were accounted for in the analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median (25th\u201375th percentile) follow\u2010up in the study was 12.6 (6.9, 18.2) years. The prevalence of VB in the present study was 3%. At the end of the follow\u2010up, there were 1320 cancer cases among the VB\u2010affected delivery cohort, 40,420 among the VB\u2010unaffected delivery cohort, 10,300 among the termination cohort and 4790 among the miscarriage cohort. HRs for any cancer among VB\u2010affected deliveries were 1.03 (95% CI 0.97, 1.08) compared with VB\u2010unaffected deliveries, 1.03 (95% CI 0.97, 1.09) compared with terminations and 0.90 (95% CI 0.84, 0.95) compared with miscarriages. There were no increased risks of premenopausal breast cancer, cervical cancer, ovary and fallopian tube cancer or uterine cancer following VB\u2010affected deliveries vs. comparison cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no evidence of an association between vaginal bleeding in pregnancy and an increased risk of cancer.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13001","type":"journal-article","created":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T04:44:25Z","timestamp":1692074665000},"page":"330-342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between vaginal bleeding in pregnancy that resulted in delivery and risk of cancer: A Danish registry\u2010based cohort study"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4238-049X","authenticated-orcid":false,"given":"Elena","family":"Dudukina","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erzs\u00e9bet","family":"Horv\u00e1th\u2010Puh\u00f3","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"Ehrenstein","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4693"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-06748-3"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0301-2115(95)02236-8"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01496.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115195"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000199952.82151.de"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02427.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.04.002"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1992.tb13697.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh277"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11618.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-2002-z"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.01193.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1813730"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta24330"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.7.1505"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kww003"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1261-4"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00683-8"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature01322"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810387965"},{"key":"e_1_2_10_24_1","first-page":"320","article-title":"The Danish medical birth registry","volume":"45","author":"Knudsen LB","year":"1998","journal-title":"Dan Med Bull"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-018-0356-1"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394715"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811408483"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811405098"},{"key":"e_1_2_10_29_1","unstructured":"Statistics Denmark.https:\/\/www.dst.dk\/en. 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