Project 453944

Autoimmune diseases are chronic immune-mediated conditions that are up to 9 times more common in females compared to males, and are a leading source of disability and premature death in women. Knowledge of risk factors specific to women is essential for informing early diagnosis and treatment that can mitigate disease progression. Pregnancy is supported by a coordinated immune response from the female body, and the onset of pregnancy complications like preeclampsia, fetal growth restriction, and spontaneous preterm birth which involve high inflammation or an abnormal immune response may foreshadow women's risk of experiencing autoimmune disease in the years after giving birth. The proposed research will investigate the association between pregnancy complications and autoimmune disease risk in women during the reproductive and middle-age years using sophisticated biostatistical methods applied to nearly two decades of health records data for the entire province of Ontario. We will examine how this association changes as women age and by type of complication and autoimmune disease; whether it is partly explained by obstetric care interventions that may promote inflammation like cesarean delivery; and if it is exacerbated by existing social inequities that affect prenatal health and chronic disease risk. Findings can be used to facilitate earlier detection of autoimmune disease via screening after a complex pregnancy and will advance new insights on female-specific causes of autoimmune disease.