title: Reproductive and hormonal risk factors for antinuclear antibodies (ANA) in a representative sample of U.S. women.
abstract: BACKGROUND
  Autoantibodies are of growing interest in cancer research as potential biomarkers; yet, the determinants of autoimmunity are not well understood. Antinuclear antibodies (ANA) are common in the general population and are more prevalent in women and older adults. Here, we examined the relationship of ANA with reproductive and hormonal factors in a representative sample of U.S. women.
  
  
  METHODS
  We analyzed data on reproductive history and exogenous hormone use in relation to serum ANA in 2,037 females ages 12 years and older from the National Health and Nutrition Examination Survey (NHANES; 1999-2004). Estimated ANA prevalences were adjusted for sampling weights. Prevalence ORs (POR) and 95% confidence intervals (CI) were adjusted for age, race, and poverty-income ratio, and models were stratified by menopause status.
  
  
  RESULTS
  In premenopausal women ages 20 years and older, ANA prevalence was associated with parity (P < 0.001; parous vs. nulliparous POR = 2.0; 95% CI, 1.2-3.4), but in parous women, ANA did not vary by number of births, age at first birth, years since last birth, or breastfeeding. In postmenopausal women, ANA prevalence was associated with an older age at menarche (P = 0.019; age 16-20 vs. 10-12 years POR = 3.0; 95% CI, 1.6-5.9), but not with parity. Oral contraceptives and estrogen therapy were not associated with a higher ANA prevalence.
  
  
  CONCLUSIONS
  Childbearing (having had one or more births) may explain age-associated elevations in ANA prevalence seen in premenopausal women.
  
  
  CONCLUSIONS
  These findings highlight the importance of considering reproductive history in studies of autoimmunity and cancer in women.
authors.affiliation: National Institute of Environmental Health Science, NIH, Research Triangle Park, North Carolina. Parks1@mail.nih.gov.
authors.forename: Christine G
authors.initials: CG
authors.lastname: Parks
authors.affiliation: National Institute of Environmental Health Science, NIH, Bethesda, Maryland.
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Miller
authors.affiliation: University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Satoh
authors.affiliation: University of Florida, Gainesville, Florida.
authors.forename: Edward K L
authors.initials: EK
authors.lastname: Chan
authors.affiliation: Social and Scientific Systems, Research Triangle Park, North Carolina.
authors.forename: Zhanna
authors.initials: Z
authors.lastname: Andrushchenko
authors.affiliation: National Institute of Environmental Health Science, NIH, Research Triangle Park, North Carolina.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Birnbaum
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Jusko
authors.affiliation: National Institute of Environmental Health Science, NIH, Research Triangle Park, North Carolina.
authors.forename: Grace E
authors.initials: GE
authors.lastname: Kissling
authors.affiliation: University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Mehul D
authors.initials: MD
authors.lastname: Patel
authors.affiliation: Social and Scientific Systems, Research Triangle Park, North Carolina.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rose
authors.affiliation: National Institute of Environmental Health Science, NIH, Research Triangle Park, North Carolina.
authors.forename: Clarice
authors.initials: C
authors.lastname: Weinberg
authors.affiliation: National Institute of Environmental Health Science, NIH, Research Triangle Park, North Carolina.
authors.forename: Darryl C
authors.initials: DC
authors.lastname: Zeldin
authors.affiliation: National Institute of Environmental Health Science, NIH, Research Triangle Park, North Carolina.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
mesh_terms: D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000378:metabolism*; D002648:Child; D005260:Female; D006728:Hormones; D006801:Humans; D008875:Middle Aged; D017584:Reproductive History; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D006728:Hormones
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