Primary Cesarean delivery and future risk of maternal autoimmune disease: a population-based cohort study
Scime NV, Grandi SM, De Vera MA, Dennis CL, Boblitz A, Brown HK. J Autoimmun. 2025; 151:103370. Epub 2025 Feb 1.
Background — During pregnancy, various maternal IgG antibodies are transferred to the developing fetus, some of which may protect the newborn against infection. If a mother and her fetus have different ABO blood groups, then transferred maternal antibodies may plausibly protect the infant against infection.
Aim — To determine if maternal-newborn ABO blood group incongruence vs. congruence is associated with a lower risk of serious infection in the infant.
Design — Retrospective population-based cohort.
Methods — We used linked patient-level datasets for all singleton hospital livebirths from 2008-2022 in Ontario, Canada, with known maternal and newborn ABO blood groups. We used a dichotomous exposure state, either ABO blood group congruent (N = 114,507) or incongruent (N = 43,074). The main outcome of interest was the risk of serious infant infection within 27 days, and from 28-365 days, after birth. Cox proportional hazard models generated hazard ratios and 95% confidence intervals, and were adjusted for maternal age, world region of origin, residential income quintile, and gestational age at birth.
Results — Relative to maternal-newborn congruency, incongruent ABO blood group was associated with aHR of 0.88 (95% CI 0.80 to 0.97) for serious neonatal infection within 27 days of birth, and 0.93 (95% CI 0.90 to 0.96) for serious infection between 28-365 days after birth.
Conclusions — Maternal-newborn ABO incongruence may be associated with a lower relative risk of a serious infant infection within 27 days, and from 28 to 365 days, after birth.
Butler EA, Grandi SM, Matai L, Wang X, Cohen E, Ray JG. QJM. 2024; Feb 24 [Epub ahead of print].
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