title: Mortality rate in children born to mothers and fathers with celiac disease: a nationwide cohort study.
abstract: Celiac disease (CD) is associated with increased mortality rate and adverse pregnancy outcome, but little is known about offspring mortality rate. In this nationwide retrospective cohort study, we identified persons whose biopsy-verified CD was diagnosed in Sweden in 1969-2008. We compared mortality rates in children born to mothers with and without CD (n = 16,121 vs. n = 61,782) and children born to fathers with and without CD (n = 9,289 vs. n = 32,984). Median age of offspring at end of follow-up was 28.7 (range, 16.7-39.7) years. We also examined mortality rates in children born to mothers with undiagnosed CD (later CD diagnosis; n = 12,919) and diagnosed CD (n = 3,202) to determine if intrauterine exposures associated with CD could affect offspring mortality rate. We estimated hazard ratios for death by using Cox regression. Death rates were independent of maternal CD (60 deaths per 100,000 person-years in children of mothers with CD, vs. 54 in controls) and paternal CD (53 deaths per 100,000 person-years in children of fathers with CD, vs. 53 in controls). Corresponding adjusted hazard ratios were 1.09 (95% confidence interval: 0.95, 1.26) for maternal CD and 1.02 (95% confidence interval: 0.85, 1.23) for paternal CD. Death rates were similar in children born to mothers with undiagnosed CD and in children whose mothers had diagnosed CD during pregnancy. Parental CD does not seem to influence mortality rate in offspring, which suggests that neither genetic influences of CD nor intrauterine conditions have adverse effects on offspring mortality rate.
authors.affiliation: Cancer Epidemiology Unit, Centro di Rieferimento per L’Epidemiologia e la Prevenzione Oncologica in Piemonte and University of Turin, Turin, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Zugna
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Richiardi
authors.forename: Olof
authors.initials: O
authors.lastname: Stephansson
authors.forename: Sven
authors.initials: S
authors.lastname: Cnattingius
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
mesh_terms: D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000453:epidemiology* / Q000401:mortality; D004522:Educational Status; D005220:Fathers / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: autoimmunity; celiac disease; death; inflammation; mortality; pregnancy