Higher Risk Of Arthritis Later In Life For Those With Infections During Infancy

Swedish researchers report in the Annals of the
Rheumatic Diseases that there is an increase in the risk of
developing arthritis in early adulthood if a child has a serious
infection during the first year of his or her life.



Cecilia Carlens (Rheumatology Unit, Department of Medicine, Karolinska
University Hospital and Institute, Stockholm, Sweden) and colleagues
studied data from national registers on over 3,500 people born between
1973 and 2002. The researchers had access to data on hospital
treatments and episodes of arthritic disease as well as information on
mother's health, details of pregnancy and birth, and details of any
infections during the first 12 months of the participants' lives.



The results of the analysis demonstrated that being born early, small,
or underweight was associated with a lower likelihood of
developing rheumatoid arthritis as a young adult. Having more
than three siblings and being large for gestational age were traits
linked to a higher probability of rheumatoid arthritis, but
these relationships were not statistically significant. In addition, a
form of arthritis that affects only young children and teens - juvenile
idiopathic arthritis - was found in participants who had a
longer-than-average gestational period.



The researchers note, however, that the most significant predictor of
arthritis was a hospital stay due to an infection during the first year
of life. This characteristic was associated with a doubling of the
likelihood of developing rheumatoid arthritis as a young adult,
especially of developing a subtype called seronegative rheumatoid
arthritis. Carlens and colleagues also found that serious infections
almost double the risk of juvenile idiopathic arthritis, with greater
risks if the child had respiratory, gut, or skin/soft tissue infections.



An explanation of the association between infections and arthritis
begins with the possibility that infections act as acute triggers of
arthritis in later life, and the researchers suggest that infections
may alter the way in which the immature immune system develops.



Perinatal characteristics, early life infections and later
risk of rheumatoid arthritis and juvenile idiopathic arthritis

C Carlens, L Jacobsson, L Brandt, S Cnattingius, O Stephansson, J
Askling

Annals of the Rheumatic Diseases (2008).

doi: 10.1136/ard.2008.089342

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Written by: Peter M Crosta