title: Birth Outcomes in Women with a History of Juvenile Idiopathic Arthritis.
abstract: OBJECTIVE
  To determine whether children born to women who had juvenile idiopathic arthritis (JIA) had more adverse birth outcomes than children born to mothers who never had JIA.
  
  
  METHODS
  Our cohort study used data from physician billing and hospitalizations covering the province of Quebec, Canada. We identified all women with JIA with a first-time birth between January 1, 1983, and December 31, 2010, and assembled a control cohort of first-time mothers without JIA from the same administrative data, matching 4:1 for date of first birth, maternal age, and area of residence. We compared outcomes (stillbirth, prematurity, small for gestational age, and major congenital anomalies) in the JIA versus non-JIA groups using logistic regression.
  
  
  RESULTS
  Mean age at delivery was 24.7 years in the JIA group (n = 1681) and 25.0 years for the non-JIA group (n = 6724). Women who had JIA were at higher risk for a premature baby [adjusted relative risk (RR) 1.20, 95% CI 1.01-1.42], a baby small for gestational age (adjusted RR 1.19, 95% CI 1.04-1.37), and a child with a congenital malformation (adjusted RR 6.51, 95% CI 5.05-8.39). Neural tube defects were higher in the JIA offspring: 1.61% (95% CI 1.11-2.33) versus 0.03% (95% CI 0.01-0.11) in the non-JIA group, as were congenital heart defects: 1.07% (95% CI 0.68-1.69) versus 0.58% (95% CI 0.42-0.79).
  
  
  CONCLUSIONS
  Most women with JIA will deliver a normal baby, even though they are at higher risk for having a child with adverse birth outcomes. Research is needed to understand pathophysiologic mechanisms and to investigate the effects of medications during childhood and youth on future birth outcomes.
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine. debbie.feldman@umontreal.ca.
authors.forename: Debbie
authors.initials: D
authors.lastname: Ehrmann Feldman
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Évelyne
authors.initials: É
authors.lastname: Vinet
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Ciarán
authors.initials: C
authors.lastname: Duffy
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Beth
authors.initials: B
authors.lastname: Hazel
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Garbis
authors.initials: G
authors.lastname: Meshefedjian
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Sylvestre
authors.affiliation: From the École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada.D. Ehrmann Feldman, PhD, École de réadaptation, Université de Montréal, and Direction de Santé Publique de Montréal, and Centre de recherche interdisciplinaire de réadaptation de Montréal, and Institut de recherche en santé publique de l'université de Montréal; É. Vinet, MD, McGill University Health Centre; S. Bernatsky, MD, PhD, McGill University Health Centre, Division of Clinical Epidemiology; C. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, and Faculty of Medicine, University of Ottawa; B. Hazel, MD, McGill University Health Centre; G. Meshefedjian, PhD, Direction de Santé Publique de Montréal; M.P. Sylvestre, PhD, Département de médecine sociale et préventive, Université de Montréal; A. Bérard, PhD, Faculté de pharmacie, Université de Montréal et Centre de recherche CHU Ste-Justine.
authors.forename: Anick
authors.initials: A
authors.lastname: Bérard
mesh_terms: D001171:Arthritis, Juvenile; D016241:Child of Impaired Parents; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D050497:Stillbirth
keywords: COHORT STUDY; CONGENITAL MALFORMATIONS; JUVENILE IDIOPATHIC ARTHRITIS