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Intrahepatic cholestasis of pregnancy and cancer, immune-mediated and cardiovascular diseases: A population-based cohort study.
- Source :
-
Journal of hepatology [J Hepatol] 2015 Aug; Vol. 63 (2), pp. 456-61. Date of Electronic Publication: 2015 Mar 12. - Publication Year :
- 2015
-
Abstract
- Background & Aims: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. It is associated with hepatobiliary diseases that might predispose to cancer and also with gestational diabetes and preeclampsia. In this study, we examined associations between ICP and cancer, and immune-mediated and cardiovascular diseases.<br />Methods: By linking the Swedish Medical Birth Register and the Swedish Patient Register, we identified 11,388 women with ICP and 113,893 matched women without ICP who gave birth between 1973 and 2009. Diagnoses of cancer and immune-mediated and cardiovascular diseases both before and after delivery were obtained from the Patient Register. The main outcome measures were hazard ratios (HRs), calculated through Cox regression, for the indicated diseases after delivery.<br />Results: ICP was not associated with later overall cancer (HR 1.07, 95% confidence interval [CI] 0.94-1.21), but it was associated with later liver and biliary tree cancer (HR 3.61, 95% CI 1.68-7.77, and 2.62, 95% CI 1.26-5.46, respectively). ICP was also associated with later immune-mediated diseases (HR 1.28, 95% CI 1.19-1.38), and specifically diabetes mellitus (HR 1.47, 95% CI 1.26-1.72), thyroid disease (HR 1.30, 95% CI 1.14-1.47), psoriasis (HR 1.27, 95% CI 1.07-1.51), inflammatory polyarthropathies (HR 1.32, 95% CI 1.11-1.58) and Crohn's disease (HR 1.55, 95% CI 1.14-2.10), but not ulcerative colitis (HR 1.21, 95% CI 0.93-1.58). Women with ICP also had a small increased risk of later cardiovascular disease (HR 1.12, 95% CI 1.06-1.19).<br />Conclusions: Women with ICP have increased risk of later hepatobiliary cancer and immune-mediated and cardiovascular diseases.<br /> (Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Cardiovascular Diseases epidemiology
Cholestasis, Intrahepatic epidemiology
Female
Humans
Incidence
Infant, Newborn
Pregnancy
Pregnancy Complications epidemiology
Pregnancy Complications, Neoplastic epidemiology
Pregnancy Outcome
Retrospective Studies
Risk Factors
Sweden epidemiology
Cardiovascular Diseases etiology
Cholestasis, Intrahepatic complications
Population Surveillance methods
Pregnancy Complications, Neoplastic etiology
Registries
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0641
- Volume :
- 63
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 25772037
- Full Text :
- https://doi.org/10.1016/j.jhep.2015.03.010