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Ann Rheum Dis. 2013 Mar;72(3):350-6. doi: 10.1136/annrheumdis-2011-201083. Epub 2012 May 14.

Childhood socioeconomic factors and perinatal characteristics influence development of rheumatoid arthritis in adulthood.

Author information

1
Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC 27599, USA. Parks1@mail.nih.gov

Erratum in

  • Ann Rheum Dis. 2013 May;72(5):788.

Abstract

BACKGROUND:

Rheumatoid arthritis (RA) has been associated with lower socioeconomic status (SES), but the reasons for this are not known.

OBJECTIVE:

To examine childhood SES measures, SES trajectory and other perinatal factors in relation to RA.

METHODS:

The sample included 50 884 women, aged 35-74 (84% non-Hispanic white) enrolled 2004-9 in a US national cohort study. In baseline questionnaires, cases (N=424, 0.8%) reported RA diagnosis after age 16, ever use of disease-modifying antirheumatic drugs or steroids for RA and ≥6 weeks bilateral joint swelling. Childhood SES measures are presented as OR and 95% CI adjusted for age and race/ethnicity. Analyses of perinatal factors also adjusted for childhood SES, and joint effects of childhood and adult SES and smoking exposures were evaluated.

RESULTS:

Patients with RA reported lower childhood household education (<12 years vs college degree; OR=1.7; 95% CI 1.1 to 2.5), food insecurity (OR=1.5, 95% CI 1.1 to 2.0) and young maternal age (<20 vs 20-34 years; OR=1.7, 95% CI 1.2 to 2.5), with a trend (p<0.0001) for increasing number of adverse factors (OR=3.0; 95% CI 1.3 to 7.0; 4 vs 0 factors) compared with non-cases. Low birth weight (<2500 g) [corrected] and preconception paternal smoking were independently associated with RA. Together, lower childhood SES and adult education (<college degree) were associated with RA (interaction p=0.03), with a joint effect magnitude similar to a history of paternal and adult smoking.

CONCLUSIONS:

RA was associated with low childhood SES sustained into adulthood, with cumulative effects across multiple measures, suggesting the importance of other unmeasured factors linking SES and RA.

PMID:
22586176
PMCID:
PMC5029277
DOI:
10.1136/annrheumdis-2011-201083
[Indexed for MEDLINE]
Free PMC Article

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