Influence of HLA-class II incompatibility between mother and fetus on the development and course of rheumatoid arthritis of the mother

doi:10.1136/ard.57.5.286

Annals of the Rheumatic Diseases 1998;57:286-290; doi:10.1136/ard.57.5.286

Ann Rheum Dis 1998;57:286-290 ( May )

Extended reports

Influence of HLA-class II incompatibility between mother and fetus on the development and course of rheumatoid arthritis of the mother I E van der Horst-Bruinsma,^a R R P de Vries,^b P D M de Buck,^a P W van Schendel,^a F C Breedveld,^a G M Th Schreuder,^b J M W Hazes^a

^a Departments of Rheumatology, ^b and Immunohaematology and Bloodbank, ^c Leiden University Medical Centre, Leiden, the Netherlands

Correspondence to: Dr I E van der Horst-Bruinsma, Leiden University Hospital, Department of Rheumatology, C4-R, PO Box 9600, 2300 RC Leiden, the Netherlands.

Accepted for publication 17 March 1998

OBJECTIVE $---$ To assess the relation between the course of rheumatoid arthritis (RA) during pregnancy or the onset of RA postpartum andDRB1, DQA1, and DQB1 incompatibilities between mother andchild.
METHODS $---$ In 45 pregnancies of 33 RA patients the course of RA was related to the number of class II incompatibilities. Furthermoreclass II incompatibilities in 16 pregnancies followed by RA onsetwere compared with those in 87 controlpregnancies.
RESULTS $---$ The risk of a favourable compared with an unfavourable course was 0.95, 2.67, and 2.38 in case of DRB1, DQA1, and DQB1 incompatibilityrespectively. DQA1 and DQB1 incompatibilities were seen more oftenin the 10 pregnancies followed by RA onset within three monthsthan in control pregnancies (OR 8.02, 95% CI 0.97, 66.06 and OR8.79 95% CI 1.07, 72.46respectively).
CONCLUSIONS $---$ DQA1 and DQB1 incompatibility between mother and child seems to have a favourable effect on the course of RA and may postponethe risk of RA onset duringpregnancy.

Keywords: pregnancy; rheumatoid arthritis; HLA; incompatibility

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