title: Parity and the risk of autoimmune thyroid disease: a community-based study.
abstract: BACKGROUND
  Recent studies have suggested that fetal microchimerism (transplacental passage of fetal cells followed by engraftment into maternal tissues) may play a role in the pathogenesis of autoimmune thyroid disease. If that is true, then parity should be a risk factor for autoimmune thyroid disease.
  
  
  OBJECTIVE
  The objective of this study was to examine parity as a risk factor for autoimmune thyroid disease.
  
  
  METHODS
  TSH, thyroid peroxidase antibody, and thyroglobulin antibody concentrations were measured on archived sera from 1045 female participants in a 1981 community health survey in Busselton, Western Australia.
  
  
  METHODS
  Odds ratios (ORs) for positive thyroid antibodies (increased concentration of either antibody) or thyroid dysfunction (abnormal serum TSH) were used.
  
  
  RESULTS
  After adjustment for age, women who had previously been pregnant did not have a significantly increased risk of positive thyroid antibodies [OR, 1.20; 95% confidence interval (CI), 0.74-1.97; P = 0.46], raised TSH (OR, 0.93; 95% CI, 0.46-1.87; P = 0.84), or reduced TSH (OR, 0.87; 95% CI, 0.33-2.30; P = 0.79) compared with women who had never been pregnant. For each additional pregnancy, the OR was 1.02 (95% CI, 0.94-1.11; P = 0.57) for positive antibodies, 1.02 (95% CI, 0.91-1.14; P = 0.67) for raised TSH, and 1.03 (95% CI, 0.87-1.22; P = 0.73) for reduced TSH. Analysis using number of live births gave similar results. The results were similar in younger and older women.
  
  
  CONCLUSIONS
  Parity is not a risk factor for thyroid autoimmunity or thyroid dysfunction. These data do not support a key pathogenic role for fetal microchimerism in chronic autoimmune thyroid disease.
authors.affiliation: Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia. john.walsh@health.wa.gov.au
authors.forename: John P
authors.initials: JP
authors.lastname: Walsh
authors.forename: Alexandra P
authors.initials: AP
authors.lastname: Bremner
authors.forename: Max K
authors.initials: MK
authors.lastname: Bulsara
authors.forename: Peter
authors.initials: P
authors.lastname: O'Leary
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Leedman
authors.forename: Peter
authors.initials: P
authors.lastname: Feddema
authors.forename: Valdo
authors.initials: V
authors.lastname: Michelangeli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D008875:Middle Aged; D016017:Odds Ratio; D009994:Osmolar Concentration; D010298:Parity; D012306:Risk; D013954:Thyroglobulin / Q000276:immunology; D013959:Thyroid Diseases / Q000209:etiology*; D013972:Thyrotropin / Q000097:blood
chemical_list: D001323:Autoantibodies; D013972:Thyrotropin; D013954:Thyroglobulin; D007453:Iodide Peroxidase