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Previous Live Births and Induced Abortions May Precede Later Development of Graves' Hyperthyroidism

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Carlé, Allan ; Knudsen, Nils ; Jørgensen, Torben ; Thuesen, Bettina ; Karmisholt, Jesper ; Linding Andersen, Stine ; Bülow Pedersen, Inge. / Previous Live Births and Induced Abortions May Precede Later Development of Graves' Hyperthyroidism. In: European Thyroid Journal. 2019 ; Vol. 8, No. 2. pp. 70-78.

Bibtex

@article{00a8944dc2b049999b2648c999a489c9,
title = "Previous Live Births and Induced Abortions May Precede Later Development of Graves' Hyperthyroidism",
abstract = "Objective: To investigate the association between reproductive history and later development of various nosological subtypes of overt hyperthyroidism.Study Design: From the Danish population, we included incident hyperthyroid women, and for each case we recruited 4 euthyroid age-sex-region-matched controls from the same sub-population. Hyperthyroid cases/controls were: Graves' disease (GD, n = 232/928), multinodular toxic goitre (MNTG, n = 91/364), solitary toxic adenoma (STA, n = 21/84). Patients diagnosed with hyperthyroidism within 1 year after delivery including post-partum GD were excluded. In multivariate conditional regression models (reference: no reproductive events), we analysed the association between development of GD/MNTG/STA and reproductive factors such as age at menarche/menopause, reproductive span, number of pregnancies/childbirths/abortions, investigations for infertility, and years on oral contraceptives. We adjusted for possible confounders such as alcohol intake, smoking, co-morbidity, and education. Age was studied as a potential effect measure modifier.Results: GD patients diagnosed before the age of 40 years had given births more often than control subjects (OR [95{\%} CI] for 1/2/3+ births [ref.: nulliparous] were 1.57 [0.80-3.11]/2.06 [1.001-4.22]/3.07 [1.50-6.26]), and they had induced abortions performed more often (OR for 1/2+ induced abortions [ref.: no: events] were 0.99 [0.54-1.84]/2.24 [1.12-4.45]). No associations were observed between any reproductive factor and the development of MNTG or STA.Conclusions: Childbirths and induced abortions may be followed by development of Graves' hyperthyroidism after the post-partum period. This was not the case for the non-autoimmune subtypes of hyperthyroidism.",
keywords = "Abortion, Case-control study, Contraceptives, Epidemiology, Hyperthyroidism, Live births, Oestrogens, Parity, Population-based study, Pregnancy, Risk factor, Thyrotoxicosis",
author = "Allan Carl{\'e} and Nils Knudsen and Torben J{\o}rgensen and Bettina Thuesen and Jesper Karmisholt and {Linding Andersen}, Stine and {B{\"u}low Pedersen}, Inge",
year = "2019",
month = "4",
doi = "10.1159/000494836",
language = "English",
volume = "8",
pages = "70--78",
journal = "European Thyroid Journal",
issn = "2235-0640",
publisher = "Karger",
number = "2",

}

RIS

TY - JOUR

T1 - Previous Live Births and Induced Abortions May Precede Later Development of Graves' Hyperthyroidism

AU - Carlé, Allan

AU - Knudsen, Nils

AU - Jørgensen, Torben

AU - Thuesen, Bettina

AU - Karmisholt, Jesper

AU - Linding Andersen, Stine

AU - Bülow Pedersen, Inge

PY - 2019/4

Y1 - 2019/4

N2 - Objective: To investigate the association between reproductive history and later development of various nosological subtypes of overt hyperthyroidism.Study Design: From the Danish population, we included incident hyperthyroid women, and for each case we recruited 4 euthyroid age-sex-region-matched controls from the same sub-population. Hyperthyroid cases/controls were: Graves' disease (GD, n = 232/928), multinodular toxic goitre (MNTG, n = 91/364), solitary toxic adenoma (STA, n = 21/84). Patients diagnosed with hyperthyroidism within 1 year after delivery including post-partum GD were excluded. In multivariate conditional regression models (reference: no reproductive events), we analysed the association between development of GD/MNTG/STA and reproductive factors such as age at menarche/menopause, reproductive span, number of pregnancies/childbirths/abortions, investigations for infertility, and years on oral contraceptives. We adjusted for possible confounders such as alcohol intake, smoking, co-morbidity, and education. Age was studied as a potential effect measure modifier.Results: GD patients diagnosed before the age of 40 years had given births more often than control subjects (OR [95% CI] for 1/2/3+ births [ref.: nulliparous] were 1.57 [0.80-3.11]/2.06 [1.001-4.22]/3.07 [1.50-6.26]), and they had induced abortions performed more often (OR for 1/2+ induced abortions [ref.: no: events] were 0.99 [0.54-1.84]/2.24 [1.12-4.45]). No associations were observed between any reproductive factor and the development of MNTG or STA.Conclusions: Childbirths and induced abortions may be followed by development of Graves' hyperthyroidism after the post-partum period. This was not the case for the non-autoimmune subtypes of hyperthyroidism.

AB - Objective: To investigate the association between reproductive history and later development of various nosological subtypes of overt hyperthyroidism.Study Design: From the Danish population, we included incident hyperthyroid women, and for each case we recruited 4 euthyroid age-sex-region-matched controls from the same sub-population. Hyperthyroid cases/controls were: Graves' disease (GD, n = 232/928), multinodular toxic goitre (MNTG, n = 91/364), solitary toxic adenoma (STA, n = 21/84). Patients diagnosed with hyperthyroidism within 1 year after delivery including post-partum GD were excluded. In multivariate conditional regression models (reference: no reproductive events), we analysed the association between development of GD/MNTG/STA and reproductive factors such as age at menarche/menopause, reproductive span, number of pregnancies/childbirths/abortions, investigations for infertility, and years on oral contraceptives. We adjusted for possible confounders such as alcohol intake, smoking, co-morbidity, and education. Age was studied as a potential effect measure modifier.Results: GD patients diagnosed before the age of 40 years had given births more often than control subjects (OR [95% CI] for 1/2/3+ births [ref.: nulliparous] were 1.57 [0.80-3.11]/2.06 [1.001-4.22]/3.07 [1.50-6.26]), and they had induced abortions performed more often (OR for 1/2+ induced abortions [ref.: no: events] were 0.99 [0.54-1.84]/2.24 [1.12-4.45]). No associations were observed between any reproductive factor and the development of MNTG or STA.Conclusions: Childbirths and induced abortions may be followed by development of Graves' hyperthyroidism after the post-partum period. This was not the case for the non-autoimmune subtypes of hyperthyroidism.

KW - Abortion

KW - Case-control study

KW - Contraceptives

KW - Epidemiology

KW - Hyperthyroidism

KW - Live births

KW - Oestrogens

KW - Parity

KW - Population-based study

KW - Pregnancy

KW - Risk factor

KW - Thyrotoxicosis

UR - http://www.scopus.com/inward/record.url?scp=85058791183&partnerID=8YFLogxK

U2 - 10.1159/000494836

DO - 10.1159/000494836

M3 - Journal article

VL - 8

SP - 70

EP - 78

JO - European Thyroid Journal

JF - European Thyroid Journal

SN - 2235-0640

IS - 2

ER -

ID: 57369610