Mikkelsen Anders P, Egerup Pia, Ebert Julie F M, Kolte Astrid M, Nielsen Henriette S, Lidegaard Øjvind
Department of Gynaecology and Obstetrics 4232, Copenhagen University Hospital Rigshospitalet, Denmark.
Department of Clinical Oncology, Zealand University Hospital, Roskilde, Denmark.
EClinicalMedicine. 2019 Oct 9;15:80-88. doi: 10.1016/j.eclinm.2019.08.017. eCollection 2019 Oct.
Cancer is the second leading cause of death worldwide. Few studies have investigated if recurrent pregnancy loss is associated with an increased risk of cancer. We aimed to assess whether pregnancy loss is associated with later cancer development.
We identified all invasive cancers after age 40, among all Danish women born between January 1957 and December 1972, ensuring a full reproductive history. Cases were matched by birth year 1:10 to cancer-free controls. Women were followed until the end of 2017. The number of pregnancy losses (miscarriages or still births) was correlated to long-term cancer risk using conditional logistic regression, providing odds ratios for specific cancers with different numbers of pregnancy losses, all adjusted for age, education, and other potential confounders.
The study included 28,785 women with cancer (mean age 48.7 [SD 5.0]) and 283,294 matched controls (mean age 48.6 [SD 5.0]). We found no overall association between pregnancy loss and later development of 11 site-specific types of cancer or cancer overall. Taking the sequence of pregnancy losses into account, primary recurrent pregnancy loss (three consecutive pregnancy losses without prior live birth) was associated with later overall cancer by an odds ratio of 1.27 (1.04-1.56). Secondary recurrent pregnancy loss showed no association to cancer.
Pregnancy loss was not associated with later cancer development. Women with primary recurrent pregnancy loss had a borderline significant association to later cancer overall, this may be a chance finding.
Ole Kirk's Foundation and Copenhagen University Hospital Rigshospitalet's Research Grant.
癌症是全球第二大死因。很少有研究调查复发性流产是否与癌症风险增加有关。我们旨在评估流产是否与后期癌症发展有关。
我们确定了1957年1月至1972年12月出生的所有丹麦女性中40岁以后的所有浸润性癌症患者，并确保她们有完整的生育史。病例按出生年份以1:10的比例与无癌对照进行匹配。对女性进行随访至2017年底。使用条件逻辑回归分析流产（自然流产或死产）次数与长期癌症风险的相关性，得出不同流产次数的特定癌症的优势比，并对年龄、教育程度和其他潜在混杂因素进行了调整。
该研究纳入了28785名癌症女性患者（平均年龄48.7岁[标准差5.0]）和283294名匹配的对照者（平均年龄48.6岁[标准差5.0]）。我们发现流产与11种特定部位的癌症或总体癌症的后期发展之间没有总体关联。考虑到流产的顺序，原发性复发性流产（连续三次流产且此前无活产）与后期总体癌症的关联优势比为1.27（1.04 - 1.56）。继发性复发性流产与癌症无关联。
流产与后期癌症发展无关。原发性复发性流产的女性与后期总体癌症有边缘性显著关联，这可能是偶然发现。
奥莱·柯克基金会和哥本哈根大学医院里格霍斯医院的研究基金。
