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Ann Rheum Dis. 2016 Oct;75(10):1831-7. doi: 10.1136/annrheumdis-2015-208072. Epub 2015 Dec 23.

Parental rheumatoid arthritis and long-term child morbidity: a nationwide cohort study.

Author information

1
Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
2
Section for Epidemiology, Department of Public Health, University of Aarhus, Aarhus, Denmark Research Unit of Gynecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.
3
Department of Clinical Epidemiology, University of Aarhus, Aarhus, Denmark Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
4
Children's Hospital Oakland Research Institute, Oakland, California, USA.
5
Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet and Glostrup Hospital, Glostrup, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
6
Department of Obstetrics and Gynecology, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
7
Gynaecological Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Virus, Lifestyle and Genes Unit, Danish Cancer Society Research Centre, Copenhagen, Denmark.

Abstract

OBJECTIVE:

To estimate the influence of parental rheumatoid arthritis (RA) on child morbidity.

DESIGN:

Nationwide cohort study.

SETTING:

Individual linkage to nationwide Danish registries.

PARTICIPANTS:

All singletons born in Denmark during 1977-2008 (n=1 917 723) were followed for an average of 16 years.

MAIN OUTCOME MEASURES:

Adjusted HRs for child morbidity; that is, 11 main diagnostic groups and specific autoimmune diseases within the International Classification of Diseases 8th and 10th versions.

RESULTS:

Compared with unexposed children, children exposed to maternal RA ('clinical' and 'preclinical') (n=13 566) had up to 26% higher morbidity in 8 of 11 main diagnostic groups. Similar tendencies were found in children exposed to paternal RA ('clinical' and 'preclinical') (n=6330), with statistically significantly higher morbidity in 6 of 11 diagnostic groups. HRs were highest for autoimmune diseases with up to three times increased risk of juvenile idiopathic arthritis (HR, 95% CI 3.30, 2.71 to 4.03 and 2.97, 2.20 to 4.01) and increased risk of up to 40% of diabetes mellitus type 1 (HR, 95% CI 1.37, 1.12 to 1.66 and 1.44, 1.09 to 1.90) and up to 30% increased HR of asthma (HR, 95% CI 1.28, 1.20 to 1.36 and 1.15, 1.04 to 1.26). Conclusions were roughly similar for children exposed to maternal clinical RA and for children only followed up to 16 years of age.

CONCLUSION:

Children of parents with RA had consistent excess morbidity. If the associations reflect biological mechanisms, genetic factors seem to play an important role. These findings call for attention given to children of parents with RA.

KEYWORDS:

Early Rheumatoid Arthritis; Epidemiology; Rheumatoid Arthritis

PMID:
26698849
PMCID:
PMC4919218
DOI:
10.1136/annrheumdis-2015-208072
[Indexed for MEDLINE]
Free PMC Article

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