Maternal rheumatoid arthritis increases risk of ASD in offsprings

A new study by Weiyao Yin and team showed that maternal Rheumatoid Arthritis (RA) before birth was linked to an elevated incidence of Autism Spectrum Disorder (ASD) in Sweden. The findings of this study were published in Psychological Medicine.

Maternal Rheumatoid Arthritis has been linked to an increased risk of Autism Spectrum Disorder in kids, mostly through inflammation/autoimmunity, although the link is not apparent. As a result, a prospective population-based cohort research was conducted to investigate the relationship between maternal RA and offspring ASD.

Researchers included all infants born alive in Sweden between 1995 and 2015, and they were followed up on until 2017. ASD and RA diagnoses were obtained clinically from the National Patient Register. After adjusting for possible confounders, we calculated hazard ratios (HR) and two-sided 95% confidence intervals (CI) from Cox regression. They looked at RA serostatus, etiological groupings, and exposure time. To investigate the underlying mechanism of the link further, we added arthralgia as a negative control group for RA, which has comparable symptomology to RA but is devoid of inflammation/autoimmunity.

The key findings of this study were:

1. 70 (1.94%) of the 3629 children born to RA women were diagnosed with ASD, compared to 28 892 (1.92%) of the 1 503 908 children delivered to non-RA moms.

2. Maternal RA before delivery was linked to an elevated risk of offspring ASD, particularly in seronegative RA.

3. There was no such link found for paternal RA, maternal sisters with RA, or RA diagnosed after birth. Maternal arthralgia, like maternal RA, was associated with a high incidence of child ASD.

This indicates an increased ASD risk associated with RA exposure prior to delivery. Maternal arthralgia, a non-inflammatory illness, had comparable high odds for ASD as did maternal RA, regardless of when the arthralgia was diagnosed. This shows that alternate or extra risk routes to autoimmunity/inflammation exist in RA.

Reference:

Yin, W., Norrbäck, M., Levine, S. Z., Rivera, N., Buxbaum, J. D., Zhu, H., Yip, B., Reichenberg, A., Askling, J., & Sandin, S. (2023). Maternal rheumatoid arthritis and risk of autism in the offspring. In Psychological Medicine (pp. 1–9). Cambridge University Press (CUP). https://doi.org/10.1017/s0033291723000855