Background: Rheumatoid arthritis (RA) is an autoimmune disease frequently affecting women during childbearing years. There is evidence suggesting children born to women with RA may have increased risk of autism, heart defects, and hematological cancers (leukemias, lymphomas)compared to children from general population. In addition, although previous studies have shown that RA patients are heavy consumers of health-care services and that RA pregnancies are at a higher risk of complications, no one has evaluated health-care costs occurring in RA pregnancies compared to pregnancies from general population.
Objectives: My research program objectives are to determine if RA offspring have increased risk of autism, heart defects, and hematological cancers compared to children from general population, as well as to evaluate if RA pregnancies result in higher health-care costs compared to pregnancies from general population.
Methods: I will use data from Quebec's administrative health-care databases to create the "CHildren Of Rheumatoid arthritis mothers Database (CHORD)", which will include a group of children born to RA mothers and matched control group of children born to unaffected mothers. I will then determine the diagnoses of autism, heart defects, and hematological cancers occurring in these children and calculate the risk for these health problems in RA offspring compared to the control group. I will also evaluate the health-care costs associated with RA pregnancies compared to control pregnancies.
Significance of my research: My research program will inform us on the risk of autism, heart defects, and hematological cancers faced by RA offspring and help clinicians appropriately counsel women with RA contemplating pregnancy. In addition, my study of medical costs in RA pregnancies will estimate the economic burden of RA pregnancies, determine risk factors for higher costs, and identify areas of heavy health-care use that might lead to cost-saving interventions and better management of pregnant RA women.