Parental rheumatoid arthritis and long-term child morbidity: A nationwide cohort study

Ane Lilleøre Rom; Chun Sen Wu; Jørn Olsen; Damini Jawaheer; Merete Lund Hetland; Bent Ottesen; Lina Steinrud Mørch

doi:10.1136/annrheumdis-2015-208072

Parental rheumatoid arthritis and long-term child morbidity: A nationwide cohort study

Ane Lilleøre Rom^*, Chun Sen Wu, Jørn Olsen, Damini Jawaheer, Merete Lund Hetland, Bent Ottesen, Lina Steinrud Mørch

^*Corresponding author for this work

Medicine, Rheumatology Division

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1831-1837
Number of pages	7
Journal	Annals of the rheumatic diseases
Volume	75
Issue number	10
DOIs	https://doi.org/10.1136/annrheumdis-2015-208072
State	Published - Dec 23 2015

Funding

Funding This study was supported by the National Institutes of Health (grant number 5R21AR059931-02), The Danish Council for Independent Research and The Augustinus Foundation. None of the funding sources had a role in the design or conduct of the study; the management, analysis or interpretation of the data nor in preparation, review and approval of the manuscript or decision to submit the manuscript for publication. This study was supported by the National Institutes of Health grant number 5R21AR059931-02), The Danish Council for Independent Research and The Augustinus Foundation. None of the funding sources had a role in the design or conduct of the study; the management, analysis or interpretation of the data nor in preparation, review and approval of the manuscript or decision to submit the manuscript for publication.

ASJC Scopus subject areas

Immunology and Allergy
Rheumatology
Immunology
General Biochemistry, Genetics and Molecular Biology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/annrheumdis-2015-208072

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@article{33edd72bf9a642bcb7d5b32d14b009a8,

title = "Parental rheumatoid arthritis and long-term child morbidity: A nationwide cohort study",

abstract = "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.",

author = "Rom, {Ane Lille{\o}re} and Wu, {Chun Sen} and J{\o}rn Olsen and Damini Jawaheer and Hetland, {Merete Lund} and Bent Ottesen and M{\o}rch, {Lina Steinrud}",

note = "Funding Information: Funding This study was supported by the National Institutes of Health (grant number 5R21AR059931-02), The Danish Council for Independent Research and The Augustinus Foundation. None of the funding sources had a role in the design or conduct of the study; the management, analysis or interpretation of the data nor in preparation, review and approval of the manuscript or decision to submit the manuscript for publication. Funding Information: This study was supported by the National Institutes of Health grant number 5R21AR059931-02), The Danish Council for Independent Research and The Augustinus Foundation. None of the funding sources had a role in the design or conduct of the study; the management, analysis or interpretation of the data nor in preparation, review and approval of the manuscript or decision to submit the manuscript for publication.",

year = "2015",

month = dec,

day = "23",

doi = "10.1136/annrheumdis-2015-208072",

language = "English (US)",

volume = "75",

pages = "1831--1837",

journal = "Annals of the rheumatic diseases",

issn = "0003-4967",

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TY - JOUR

T1 - Parental rheumatoid arthritis and long-term child morbidity

T2 - A nationwide cohort study

AU - Rom, Ane Lilleøre

AU - Wu, Chun Sen

AU - Olsen, Jørn

AU - Jawaheer, Damini

AU - Hetland, Merete Lund

AU - Ottesen, Bent

AU - Mørch, Lina Steinrud

N1 - Funding Information: Funding This study was supported by the National Institutes of Health (grant number 5R21AR059931-02), The Danish Council for Independent Research and The Augustinus Foundation. None of the funding sources had a role in the design or conduct of the study; the management, analysis or interpretation of the data nor in preparation, review and approval of the manuscript or decision to submit the manuscript for publication. Funding Information: This study was supported by the National Institutes of Health grant number 5R21AR059931-02), The Danish Council for Independent Research and The Augustinus Foundation. None of the funding sources had a role in the design or conduct of the study; the management, analysis or interpretation of the data nor in preparation, review and approval of the manuscript or decision to submit the manuscript for publication.

PY - 2015/12/23

Y1 - 2015/12/23

N2 - 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.

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.

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ER -

Parental rheumatoid arthritis and long-term child morbidity: A nationwide cohort study

Abstract

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