Ann Rheum Dis 1998;57:286-290 ( May )
Extended reports
Influence of HLA-class II incompatibility between mother and
fetus on the development and course of rheumatoid arthritis of the
mother
I E van der Horst-Bruinsma,a
R R P de Vries,b
P D M de Buck,a
P W van Schendel,a
F C Breedveld,a
G M Th Schreuder,b
J M W Hazesa
a Departments of Rheumatology, b and Immunohaematology and
Bloodbank, c Leiden University Medical Centre, Leiden, the Netherlands
Correspondence to: Dr I E van der Horst-Bruinsma, Leiden
University Hospital, Department of Rheumatology, C4-R, PO Box 9600, 2300 RC Leiden, the Netherlands.
Accepted for publication 17 March 1998
OBJECTIVE
To assess the relation between the
course of rheumatoid arthritis (RA) during pregnancy or the onset of RA
postpartum and DRB1, DQA1, and DQB1 incompatibilities between mother
and child.
METHODSIn 45 pregnancies of 33 RA patients the
course of RA was related to the number of class II incompatibilities.
Furthermore class II incompatibilities in 16 pregnancies followed by RA
onset were compared with those in 87 control pregnancies.
RESULTSThe risk of a favourable compared with an
unfavourable course was 0.95, 2.67, and 2.38 in case of DRB1, DQA1, and
DQB1 incompatibility respectively. DQA1 and DQB1 incompatibilities were
seen more often in the 10 pregnancies followed by RA onset within three
months than in control pregnancies (OR 8.02, 95% CI 0.97, 66.06 and OR 8.79 95% CI 1.07, 72.46 respectively).
CONCLUSIONSDQA1 and DQB1 incompatibility between
mother and child seems to have a favourable effect on the course of RA
and may postpone the risk of RA onset during pregnancy.
Keywords:
pregnancy;
rheumatoid arthritis;
HLA;
incompatibility
© 1998 by Annals of the Rheumatic Diseases
