Maternal rheumatoid arthritis and risk of autism in the offspring.

Autor:	Yin W; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China., Norrbäck M; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden., Levine SZ; School of Public Health, University of Haifa, Haifa, Israel., Rivera N; Department of Medicine Solna, Respiratory Medicine Division, Karolinska Institutet, Stockholm, Sweden.; Rheumatology Division, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden., Buxbaum JD; Seaver Autism Center for Research and Treatment at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, USA., Zhu H; Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China., Yip B; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China., Reichenberg A; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA., Askling J; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.; Rheumatology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden., Sandin S; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Seaver Autism Center for Research and Treatment at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, USA.; Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China.; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
Jazyk:	angličtina
Zdroj:	Psychological medicine [Psychol Med] 2023 Nov; Vol. 53 (15), pp. 7300-7308. Date of Electronic Publication: 2023 Apr 24.
DOI:	10.1017/S0033291723000855
Abstrakt:	Background: Maternal Rheumatoid Arthritis (RA) is suggested to increase the risk of Autism Spectrum Disorder (ASD) in the offspring, mainly through inflammation/autoimmunity, but the association is unclear. A prospective population-based cohort study was implemented to examine the association between maternal RA and offspring ASD. Methods: We included all children born alive in Sweden from 1995 to 2015, followed up through 2017. Diagnoses of ASD and RA were clinically ascertained from National Patient Register. We quantified the association by hazard ratios (HR) and two-sided 95% confidence intervals (CI), from Cox regression after detailed adjustment for potential confounders. We examined RA serostatus, etiological subgroups and the timing of exposure. To closer examine the underlying mechanism for the association, we included a negative control group for RA, arthralgia, with similar symptomology as RA but free from inflammation/autoimmunity. Results: Of 3629 children born to mothers with RA, 70 (1.94%) were diagnosed with ASD, compared to 28 892 (1.92%) of 1 503 908 children born to mothers without RA. Maternal RA before delivery was associated with an increased risk of offspring ASD (HR = 1.43, 95% CI 1.11-1.84), especially for seronegative RA (HR = 1.61, 95% CI 1.12-2.30). No similar association was observed for paternal RA, maternal sisters with RA, or RA diagnosed after delivery. Maternal arthralgia displayed as high risks for offspring ASD as did maternal RA (HR = 1.41, 95% CI 1.24-1.60). Conclusions: In Sweden, maternal RA before delivery was associated with an increased risk of offspring ASD. The comparable association between maternal arthralgia and ASD risk suggests other pathways of risk than autoimmunity/inflammation, acting jointly or independently of RA.
Databáze:	MEDLINE
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