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Parental rheumatoid arthritis and long-term child morbidity: a nationwide cohort study
  1. Ane Lilleøre Rom1,
  2. Chun Sen Wu2,3,4,
  3. Jørn Olsen5,6,
  4. Damini Jawaheer7,
  5. Merete Lund Hetland8,9,
  6. Bent Ottesen10,
  7. Lina Steinrud Mørch11,12
  1. 1Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
  2. 2Section for Epidemiology, Department of Public Health, University of Aarhus, Aarhus, Denmark
  3. 3Research Unit of Gynecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
  4. 4Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
  5. 5Department of Clinical Epidemiology, University of Aarhus, Aarhus, Denmark
  6. 6Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, USA
  7. 7Children's Hospital Oakland Research Institute, Oakland, California, USA
  8. 8Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet and Glostrup Hospital, Glostrup, Denmark
  9. 9Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
  10. 10Department of Obstetrics and Gynecology, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
  11. 11Gynaecological Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  12. 12Virus, Lifestyle and Genes Unit, Danish Cancer Society Research Centre, Copenhagen, Denmark
  1. Correspondence to Dr Ane Lilleøre Rom, Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, section 7821, Copenhagen DK-2100, Denmark; ane.lilleoere.rom{at}


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.

  • Rheumatoid Arthritis
  • Epidemiology
  • Early Rheumatoid Arthritis

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