Is There a Link Between Maternal Rheumatoid Arthritis and Chronic Disease in Children?
Women who are pregnant or who are thinking about becoming pregnant have many concerns and questions regarding pregnancy, their family, and the health of their future child. For women who have chronic conditions such as rheumatoid arthritis (RA) it is only natural that these concerns be heightened. With this painful autoimmune disease it would not be surprising to have a patient who is concerned about how pregnancy may affect the disease and make its symptoms worse. Additionally, the heritability of RA is unclear (the disease is poorly understood and there seems to be numerous genetic and environmental factors involved), so it is natural for parents to be concerned that their child will inherit the disease or have other complications.
So, what if RA increased the risk of a child developing thyroid disease or epilepsy? Recently, researchers out of the Odense University Hospital Center for Clinical Epidemiology, in Denmark showed that there is a slight increased risk for children born to mothers with RA of developing chronic diseases including thyroid disease, epilepsy, and RA during childhood.
As a result of their findings, the Danish researchers encourage pediatricians to be a little more aware of the potential for chronic diseases to develop in children who are born to mothers with RA. Line R. Jølving, MHS says that, “RA is an autoimmune disease that often aggregates in families, it affects women three times more frequently than men, and RA is one of the most common chronic diseases in pregnant women. Therefore, women with RA often have concerns about a possible negative impact of their disease on the fetus when they are contemplating pregnancy. One of their main concerns may be if there is a risk of passing RA or other diseases to their offspring.”
So how significant is this relationship?
To look at this potential connection researchers did a nationwide cohort study using Danish health registries. They looked at children born between January 1, 1989 and December 31, 2013. Included in the study were 2,106 children born by women with RA and 1,378,539 children born by women without RA. They examined the potential relationship between maternal RA and 15 different chronic diseases in children.
With the data that they collected they calculated the hazard ratio (HR) for children developing chronic conditions after being exposed to RA in utero. The data presented in the article can be difficult to understand. They report that the HR for thyroid diseases in children were 2.19 with a 95% confidence interval (CI) of 1.14-4.21. For epilepsy these numbers were HR of 1.61 (95% CI, 1.116-2.25) and for RA the HR was 2.89 (95% CI, 2.06-4.05). The potential development of other conditions that they looked at were not significantly increased.
So, what does this all mean?
While the findings are relevant and should notify pediatricians to be a little more aware of the potential for these diseases to develop in children with mothers who have RA, it does not mean that these children have a huge increased risk.
Read on to learn more about this connection.