Rheumatoid Arthritis Offspring at No Greater Mortality Risk

Aug 15, 2017

Researchers pointed out a possible link with childhood illness, such as diabetes and cardiovascular problems.

The mortality rate for the children of both women and men who have rheumatoid arthritis is no higher than that in the children of parents who do not.

The mortality rate for the children of parents with rheumatoid arthritis in whom respiratory or infectious disease developed was similar to that of children with healthy parents.

Rheumatoid arthritis is known to be associated with complications in pregnancy, such as preterm delivery and low birth weight infants. Ane Rom and fellow researchers in Denmark pointed out a possible link between parental rheumatoid arthritis and childhood illness, such as diabetes and cardiovascular problems.

A previous study showed that children of parents with rheumatoid arthritis had higher morbidity as children, which may point to genetic factors as a reason.

The authors of the current study sought to determine whether the increase in childhood morbidity in the children of parents with rheumatoid arthritis also confers greater mortality. They presented their findings in a recent Arthritis Care & Research article.

The Study

With use of the Medical Birth Registry in Denmark, 1,917,723 single birth children were included in this cohort study. Parental rheumatoid arthritis status was determined through examination of the Danish National Hospital Registry using ICD-8 codes.

The Results

• Of the included children, 13,556 were exposed to maternal rheumatoid arthritis and 6330 to paternal rheumatoid arthritis.

• 494,511 children had respiratory diseases; 6352 were exposed to parental rheumatoid arthritis.

• 271,164 children had infectious diseases; 3484 were exposed to parental rheumatoid arthritis.

• Mortality rates were similar in children of parents with rheumatoid arthritis and those with unaffected parents (hazard ratio, 0.98, 95% confidence interval, 0.84-1.15, and 1.08, 95% confidence interval, 0.86-1.36, respectively).

• Risk of death in the exposed group was not different from that in the unexposed group at age 1, 3, or 5 years.

• Hazard ratios for children with respiratory diseases and infectious diseases were 1.11 (95% confidence interval, 0.74-1.66) and 0.84 (95% confidence interval, 0.52-1.35), respectively.

• No statistical significance was found between children with respiratory disease or infectious disease exposed or not exposed to parents with rheumatoid arthritis where mortality was examined.

Implications for physicians

• The mortality rate for children of parents with rheumatoid arthritis is similar to that of children whose parents do not have rheumatoid arthritis.

• The mortality rate for children of parents with rheumatoid arthritis who contract a respiratory or infectious disease is similar to that in children with parents who do not have rheumatoid arthritis.

• Physicians can reassure parents who have rheumatoid arthritis that their children should not be at increased risk for death as a result of their disease.

Disclosures:

The NIH, the Danish Council for Independent Research, and the Augustinus Foundation provided financial support for this project.

References:

Rom AL, Wu CS, Olsen J, et al. “Parental Rheumatoid Arthritis, Child Mortality, and Case Fatality: A Nationwide Cohort Study.” Arthritis Care Res (Hoboken). 2017;69:933-937. doi: 10.1002/acr.22991. Epub 2017 May 8.

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