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Objective: Fetal exposure to maternal rheumatoid arthritis (RA) might impact the long-term risk of disease in the offspring. We examined a possible association between maternal RA and 15 selected groups of chronic diseases in the offspring. Methods: This nationwide cohort study was based on the Danish health registries and included data on all children born alive in Denmark between January 1, 1989 and December 31, 2013. The cohort comprised 2,106 children born by women with RA (exposed), and 1,378,539 children born by women without RA (unexposed). Cox proportional hazards regression models were used, taking a large range of confounders into consideration, and the hazard ratios (HRs) of child and adolescent diseases were calculated. Results: In children exposed to maternal RA in utero, the HR of thyroid diseases was 2.19 (95% confidence interval [95% CI] 1.14–4.21), epilepsy 1.61 (95% CI 1.16–2.25), and RA 2.89 (95% CI 2.06–4.05). The HRs for anxiety and personality disorders and chronic lung disease including asthma were in the range of 1.15–1.16, but these were not statistically significant associations. Conclusion: Our results suggest that in utero exposure to maternal RA is associated with an increased risk of thyroid disease and epilepsy in childhood and adolescence, and in particular an increased risk of RA, compared to children born to mothers without RA. These important findings should encourage pediatricians and general practitioners to have an increased awareness of certain chronic diseases in children exposed to RA in utero.

BACKGROUND: Very little is known about the long-term impact of maternal inflammatory bowel disease (IBD) on the offspring's future health. We aimed to examine whether children born to mothers with IBD had an increased risk of long-term morbidities.METHODS: In this nationwide register-based cohort study, including all children born alive in Denmark between 1989 and 2013, we investigated the association between maternal IBD and 15 selected disease categories of physical and mental conditions in the offspring. We used multivariate regression models estimating the hazard ratio (HR) of long-term child morbidities.RESULTS: The cohort comprised 9238 children born to women with IBD (exposed), and 1,371,407 born to women without IBD (unexposed). Median follow-up time among the exposed was 9.7 years (interquartile range [IQR] 4.9-15.7) and 13.8 (interquartile range 7.4-19.9) among the unexposed. In children, who in utero had been exposed to maternal ulcerative colitis, the HR of IBD in the offspring was 4.63 (95% confidence interval, 3.49-6.16). For maternal Crohn's disease, the HR of IBD in the offspring was 7.70 (95% confidence interval, 5.66-10.47). For all other diseases in the offspring, we did not find a significantly increased risk associated with maternal IBD.CONCLUSIONS: Children born to mothers with IBD are more likely to be diagnosed with IBD themselves, compared with children born to women without IBD. Our data otherwise do not provide evidence for an increased risk of any of the other examined diseases in the offspring.