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Rheumatology Advance Access originally published online on April 4, 2006
Rheumatology 2006 45(10):1282-1287; doi:10.1093/rheumatology/kel092
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Impaired reproductive fitness in mothers of children with juvenile autoimmune arthropathies

M. Chaudhari1, M. B. Moroldo1, E. Shear1, P. Hillard2, S. D. Thompson1, D. Lan3, B. Huang3, H. I. Brunner1 and D. N. Glass1

1Division of Rheumatology, 2Division of Adolescent Medicine and 3Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.

Correspondence to: D. N. Glass, Cincinnati Children's Hospital Medical Center, Division of Rheumatology, E.2 4010, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. E-mail: david.glass{at}cchmc.org


  Abstract

Objective. To assess the reproductive fitness of mothers of children with juvenile idiopathic arthritis (JIA).

Methods. A mail survey assessing pregnancy outcome was carried out among mothers of children with JIA (JIA mothers) treated at a tertiary paediatric rheumatology centre. The best friends of the JIA mothers served as controls. Besides family history, sociodemographics and reproductive outcomes were measured, including the number of pregnancies, pregnancy complications and gestational age at the time of delivery.

Results. JIA mothers (n = 227) and controls (n = 235) had similar sociodemographics and racial backgrounds. On average, JIA mothers reported a greater number of conceptions than controls (3.5 vs 3.1; P = 0.01) but had significantly higher rates of pregnancy complications (25% vs 15%; P<0.001). Corrected for differences in the absolute number of pregnancies between groups, the chances of having a miscarriage [mean (S.D.), 0.12 (0.18) vs 0.09 (0.16); P = 0.02] or preterm delivery [0.08 (0.21) vs 0.04 (0.15); P<0.02] were significantly greater among JIA mothers than controls.

Conclusions. Mothers of children with JIA have impaired reproductive fitness. This phenomenon is unlikely to be the result of difficulty with conception but rather to be due to higher rates of pregnancy loss and premature delivery.

KEY WORDS: Maternal reproductive fitness, Conception, JIA, JRA, Childhood autoimmunity, Pregnancy loss.

Submitted 2 November 2005; revised version accepted 17 February 2006.
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