Maternal rheumatoid arthritis during pregnancy and neurodevelopmental disorders in offspring: a systematic review

Area of Science:

• Reproductive immunology
• Developmental neuroscience
• Clinical epidemiology

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting women of reproductive age.
• In utero exposure to maternal inflammatory conditions may impact offspring neurodevelopment.
• Understanding the link between maternal RA and neurodevelopmental disorders (NDDs) is crucial for risk assessment and intervention.

Purpose of the Study:

• To systematically review and synthesize existing literature on the association between in utero exposure to maternal rheumatoid arthritis (RA) and the risk of NDDs in offspring.
• To assess the quality of evidence regarding this association.

Main Methods:

• Systematic literature review of studies investigating maternal RA and offspring NDDs.
• Quality assessment of included studies using the Newcastle Ottawa Scale.

Main Results:

• Six studies were included in the review.
• Evidence suggests a potential, moderately elevated risk for NDDs such as autism spectrum disorder, epilepsy, and attention deficit hyperactivity disorder (ADHD) in offspring exposed to maternal RA.
• Some studies indicated slightly elevated risks, while others lacked sufficient power for definitive conclusions.

Conclusions:

• The current body of research on maternal RA and offspring NDDs is limited.
• Available studies suggest a possible increased risk, but reporting bias is a concern.
• Further high-quality, well-powered studies are necessary to confirm these findings and elucidate the underlying mechanisms.