Friday, 15 Feb 2019

You are here

Maternal RA Increases Offspring Risk of Autoimmune Disorders

A Danish population study suggests that fetal exposure to maternal rheumatoid arthritis (RA) results in an increased offspring risk of thyroid disease, epilepsy and RA, compared to children born to mothers without RA.

Researchers examined a possible association between maternal RA and 15 select chronic diseases in the offspring in a national cohort study using Danish health registries. They examined 2106 children born to RA women (exposed) between 1989 and 2013 and compared outcomes to 1,378,539 children born by women without RA (unexposed).

Exposure to maternal RA resulted in an increased offspring risk for:

  • Thyroid diseases (hazard ratio [HR] 2.19; 95% confidence interval [95% CI] 1.14–4.21)
  • Epilepsy (HR 1.61; 95% CI 1.16–2.25)
  • RA 2.89 (HR 95% CI 2.06–4.05).

Increased but not significant were the odds of developing anxiety, personality disorders and chronic lung disease, including asthma (HR range of 1.15–1.16).

This registry, population-based analysis suggests in utero exposure to maternal RA is associated with an increased risk of select autoimmune conditions, including RA.  While there was a nearly 2-3 fold risk of these autoimmune conditions the overall individual risk still remained quite low (RA exposed risk to offspring was 1.6% compared with 0.7% in unexposed).

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

No Added Benefit to MRI-Guided Therapy in Rheumatoid Arthritis

A treat-to-target (T2T) strategy to manage rheumatoid arthritis hinges on clinical metrics to optimize therapy. But investigators from Denmark have shown that using magnetic resonance imaging–guided T2T failed to improve disease activity remission rates or reduce radiographic progression.

Differing Effects of Smoking and HLA-DRB1 in Seropositive Rheumatoids

Analyses from the Swedish EIRA incident rheumatoid arthritis cohort study shows that smoking and HLA-DRB1 exert differential effects on serologically defined RA subsets - but that the strongest influence was seen in double positive (CCP+, RF+) individuals.

Update on Pregnancy Management in RA

Two recent reports offer good news to rheumatoid arthritis (RA) women who are planning to become pregnant. 

The first studies, RA women experiencing fertility issues who turn to assisted reproductive technology (ART) shows that live births were significantly lower in women with rheumatoid arthritis receiving ART treatment compared to usual rates in women without rheumatoid arthritis.

Multidisciplinary Recommendations for Rheumatoid Foot Problems

Approximately 90% of patients with rheumatoid arthritis (RA) have foot problems. A multidisciplinary panel (including 2 patients, 22 professionals (rheumatologists, rehabilitation physicians, orthopaedic surgeons, specialized nurses, podiatrists, orthopaedic shoe technicians, pedicurists, researchers) in the Netherlands set out to develop recommendations for those who treat RA foot problems. 

Does Seropositivity Change with Therapy?

A subanalysis of the early rheumatoid arthritis (RA) "IMPROVED" study has shown that changes in RA-autoantibody levels are not associated with disease activity or or long-term drug response, but instead reflect intensity of immunosuppression. Thus while autoantibody levels may be modifiable by our best therapies, modifying CCP or RF levels appears to have limited clinical relevance.