Increased Congenital Anomalies in Children from Women with a Juvenile Arthritis History Save

A Quebec administrative claims analysis examined the birth outcomes of women with a history of juvenile idiopathic arthritis (JIA) who subsequently had a first-time birth (between 1983-2010).  JIA patients were matched 4:1 with normal controls from the same era and adjusted for age and residence.

The JIA women included 1681 women who had a mean age at delivery of 24.7 years compared with the non-JIA group who were 25.0 years a the time of delivery (n = 6724).

Women who had JIA were shown to have a higher risk for premature delivery [adjusted relative risk (RR) 1.20, 95% CI 1.01–1.42], small for gestational age (aRR 1.19, 95% CI 1.04–1.37), and congenital malformations (aRR 6.51, 95% CI 5.05–8.39).  Children born of JIA mothers were more likely to have neural tube defects (1.61% vs. 0.03% in the non-JIA) and congenital heart defects (1.07% vs. 0.58%).

Thus, most JIA women appear to deliver normal babies, even though they are at higher risk for having a child with adverse birth outcomes.  The increased risk of congenital anomalies requires further research to delineate whether this is constitutive, related to disease activity or drug exposures.