June 20, 2013
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Childbirth increased risk for ACPA-negative rheumatoid arthritis

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Women, aged 18 to 44 years, who delivered children were at increased risk for anti-citrullinated protein antibody-negative rheumatoid arthritis, according to research presented at the annual congress of the European League Against Rheumatism in Madrid.

Using the Swedish-population based Epidemiological Investigation of Rheumatoid Arthritis (RA) study, researchers conducted a case-control investigation of 2,035 women (aged 18 to 70 years) and 2,911 matched controls collected from 1996 to 2009. A questionnaire assessed women’s parity, age at first birth and postpartum period before RA symptoms occurred.

“It has been suggested that the risk of RA is decreased during pregnancy but increased after delivery,” researcher Cecilia Orellana, MPH, PhD candidate at the Institute of Environmental Medicine, Karolinska Institutet, Stockholm, said in a press release. “Our data demonstrate that the increased risk after delivery is only associated with anti-citrullinated protein antibody (ACPA)-negative RA, and not ACPA-positive RA.”

Researchers observed an increased risk for the condition in women, aged 18 to 44 years, but not older women, who delivered a child (OR=2.1; 95% CI, 1.4-3.2), compared with nulliparous women. The risk was more pronounced during the first year after childbirth (OR=1.8; 95% CI, 0.9-3.6) and in women who first delivered at earlier ages (P=.0158 for trend).

“Further studies are needed in order to explore the biological mechanisms behind our findings,” Orellana said. “But the effect on hormonal/reproductive factors such as parity might partly explain the higher incidence of RA in premenopausal women.”

For more information:

Orellana C. OP0149: The Association Between Parity and Rheumatoid Arthritis: Results From the Swedish EIRA Study. Presented at: EULAR 2013; June 12-15, Madrid.