RT Journal Article
SR Electronic
T1 Parental rheumatoid arthritis and long-term child morbidity: a nationwide cohort study
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1831
OP 1837
DO 10.1136/annrheumdis-2015-208072
VO 75
IS 10
A1 Ane Lilleøre Rom
A1 Chun Sen Wu
A1 Jørn Olsen
A1 Damini Jawaheer
A1 Merete Lund Hetland
A1 Bent Ottesen
A1 Lina Steinrud Mørch
YR 2016
UL http://ard.bmj.com/content/75/10/1831.abstract
AB 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.