Parental autoimmune diseases and offspring's allergic disease: A systematic review and meta-analysis

Epidemiological studies have reported an increased risk of allergic diseases in children born to parents with autoimmune diseases (AIDs); however, the mechanisms underlying this association remain unclear. We conducted a systematic review and meta-analysis to explore the relationship between parental AIDs and allergic diseases in offspring. EMBASE, Web of Science, and PubMed databases were searched for articles published up to December 1, 2025. AIDs in both mothers and fathers were included. Allergic outcomes included asthma, eczema, and allergic rhinitis. A random-effects model was used to synthesize the data. Twelve studies were included in the final analysis, and the methodological quality ranged from moderate to high. Maternal AIDs (of any type) were associated with an increased risk of asthma (odds ratio (OR) 1.25, 95% confidence interval (CI): 1.09-1.43), eczema (OR 1.30, 95% CI: 1.13-1.50), and allergic rhinitis (OR 1.04, 95% CI: 1.02-1.07) in offspring. Paternal AIDs were also associated with a higher risk of asthma (OR 1.16, 95% CI: 1.06-1.27) and eczema (OR 1.13, 95% CI: 1.02-1.26) in offspring. This systematic review and meta-analysis demonstrate that parental AIDs are associated with an increased risk of asthma and eczema in children. However, the available evidence is limited by potential bias in case ascertainment and inadequate adjustment for confounding factors. Larger high-quality studies are needed to confirm these findings and to elucidate the underlying genetic and microbiome-related mechanisms. Such evidence may facilitate early identification and targeted prevention or management of allergic diseases in children of parents with AIDs.