Department of Public Health, Aarhus University, Aarhus.
Department of Rheumatology, Aarhus University Hospital, Aarhus.
Rheumatology (Oxford). 2020 Aug 1;59(8):1871-1877. doi: 10.1093/rheumatology/kez538.
RA and SLE are the most prevalent autoimmune rheumatic diseases affecting young women. Both diseases are characterized by systemic inflammation that may affect placental function and fetal development during pregnancy, and both diseases are associated with adverse pregnancy and child outcomes. We investigated the associations between maternal RA or SLE and the two genital malformations, cryptorchidism and hypospadias.
In this nationwide register-based study including all male singleton live births in Denmark from 1995 to 2016, we assessed the occurrence of cryptorchidism and hypospadias according to the prenatal disease-state of the mothers. Using Cox proportional hazards models we calculated adjusted hazard ratios, accounting for varying age at diagnosis.
Among 690 240 boys, 1026 had a mother with RA and 352 had a mother with SLE. We found adjusted hazard ratios of 1.72 (95% CI: 1.15; 2.57) for cryptorchidism among boys born to mothers with RA and 1.46 (95% CI: 0.69; 3.06) for boys born to mothers with SLE, compared with the general population. As the number of hypospadias cases was low, multivariate analysis was not feasible. The crude hazard ratios were 0.51 (95% CI: 0.16; 1.58) and 1.00 (95% CI: 0.25; 4.03) for RA and SLE, respectively.
Boys born to mothers with RA had higher risk of cryptorchidism, compared with unexposed boys. Boys born to mothers with SLE showed a similar tendency, however with less precision of the estimate. No conclusion could be reached on the risk of hypospadias, due to the low number of events.
类风湿关节炎（RA）和系统性红斑狼疮（SLE）是最常见的影响年轻女性的自身免疫性风湿性疾病。这两种疾病都有全身炎症的特点，可能会在怀孕期间影响胎盘功能和胎儿发育，而且这两种疾病都与不良的妊娠和儿童结局有关。我们研究了母体 RA 或 SLE 与两种生殖器畸形（隐睾和尿道下裂）之间的关联。
在这项基于全国注册的研究中，我们纳入了 1995 年至 2016 年期间丹麦所有男性单胎活产儿，根据母亲的产前疾病状态评估隐睾症和尿道下裂的发生情况。我们使用 Cox 比例风险模型计算了调整后的危险比，考虑了不同的诊断年龄。
在 690240 名男孩中，有 1026 名男孩的母亲患有 RA，352 名男孩的母亲患有 SLE。我们发现，与普通人群相比，患有 RA 的母亲所生的男孩患隐睾症的调整后危险比为 1.72（95%可信区间：1.15；2.57），而患有 SLE 的母亲所生的男孩患隐睾症的危险比为 1.46（95%可信区间：0.69；3.06）。由于尿道下裂病例数量较少，因此无法进行多变量分析。RA 和 SLE 的粗危险比分别为 0.51（95%可信区间：0.16；1.58）和 1.00（95%可信区间：0.25；4.03）。
与未暴露于 RA 的男孩相比，患有 RA 的母亲所生的男孩患隐睾症的风险更高。患有 SLE 的母亲所生的男孩也有类似的趋势，但估计的准确性较低。由于事件数量较少，因此无法得出关于尿道下裂风险的结论。
