{"id":21141,"date":"2025-02-01T16:31:04","date_gmt":"2025-02-01T21:31:04","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21141"},"modified":"2025-02-04T17:07:41","modified_gmt":"2025-02-04T22:07:41","slug":"primary-cesarean-delivery-and-future-risk-of-maternal-autoimmune-disease","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/primary-cesarean-delivery-and-future-risk-of-maternal-autoimmune-disease\/","title":{"rendered":"Primary Cesarean delivery and future risk of maternal autoimmune disease: a population-based cohort study"},"content":{"rendered":"<p><strong>Objectives<\/strong> \u2014 To determine the association between primary Cesarean delivery and incident autoimmune disease in women.<\/p>\n<p><strong>Methods<\/strong> \u2014 We conducted a population-based cohort study of 253,901 females in Ontario, Canada with a first childbirth between 2012 and 2017 and with no pre-existing autoimmune disease. Royston-Parmar models were used to estimate the time-varying association between Cesarean delivery (28.2 % of females) versus vaginal delivery (71.8 % of females; referent) and celiac disease, multiple sclerosis (MS), rheumatoid arthritis (RA), and systemic autoimmune rheumatic disease (SARD), separately, from date of delivery to date of diagnosis or censoring at death, loss of health insurance, or March 31, 2021. To account for potential confounding by indication for Cesarean delivery, models were generated using (i) overlap weighting based on propensity scores for mode of delivery and (ii) with restriction to low-risk pregnancies free of pre-labour Cesarean indications (n = 146,887).<\/p>\n<p><strong>Results<\/strong> \u2014 At up to 9 years following childbirth (median = 6.5 years of follow-up), Cesarean delivery was associated with an increased risk of MS, but not celiac disease, RA, or SARD. Overall, cumulative incidence of MS was 0.28 % following Cesarean delivery and 0.21 % following vaginal delivery. After overlap weighting, the adjusted hazard ratio (AHR) curve formed a slight L-shape with the largest magnitude between birth and 3 years (1-year AHR 1.37, 95 % CI 1.04\u20131.69) and diminishing thereafter (5-year 1.23, 95 % CI 0.91\u20131.55; 7-year 1.21, 95 % CI 0.84\u20131.57). Results were similar when restricted to births following low-risk pregnancies.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Findings suggest a possible link between Cesarean delivery and MS development among females that warrants future replication and explanatory studies.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives \u2014 To determine the association between primary Cesarean delivery and incident autoimmune disease in women. Methods \u2014 We conducted a population-based cohort study of 253,901 females in Ontario, Canada with a first childbirth between 2012 and 2017 and with no pre-existing autoimmune disease. Royston-Parmar models were used to estimate the time-varying association between Cesarean [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[42,26],"migration-helper-qa-sample-set":[],"class_list":["post-21141","journal_article","type-journal_article","status-publish","hentry","topic-chronic-diseases-and-multimorbidity","topic-maternity-and-neonatal-care"],"acf":{"citation":"Scime NV, Grandi SM, De Vera MA, Dennis CL, Boblitz A, Brown HK. <em>J Autoimmun<\/em>. 2025; 151:103370. Epub 2025 Feb 1.","source_url":"https:\/\/doi.org\/10.1016\/j.jaut.2025.103370","ices_scientist":[1236,1164],"site":[6733],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Primary Cesarean delivery and future risk of maternal autoimmune disease: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 To determine the association between primary Cesarean delivery and incident autoimmune disease in women. Methods \u2014 We conducted a\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/primary-cesarean-delivery-and-future-risk-of-maternal-autoimmune-disease\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Primary Cesarean delivery and future risk of maternal autoimmune disease: a population-based cohort study\" \/>\n<meta property=\"og:description\" content=\"Objectives \u2014 To determine the association between primary Cesarean delivery and incident autoimmune disease in women. 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