Meta-AnalysisMolecular autism2025

Maternal rheumatoid arthritis and the risk of offspring autism spectrum disorder: two national birth cohorts and a meta-analysis.

Evora Hailin Zhu, Benjamin Hk Yip, Caroline Fyfe and 7 others

PMID 41345879

WHAT IT FOUND

Children of mothers diagnosed with rheumatoid arthritis before delivery had a higher risk of autism than children of mothers without that diagnosis.

Risk was not higher when arthritis was diagnosed after delivery. This is an association, not a proven cause.

Key findings

01Maternal rheumatoid arthritis diagnosed before delivery was associated with increased offspring autism spectrum disorder risk in the pooled Israeli cohorts and in the meta-analysis.

02Maternal rheumatoid arthritis diagnosed after delivery was not associated with increased offspring autism spectrum disorder risk in the pooled cohorts or the meta-analysis.

03When maternal rheumatoid arthritis timing was unspecified, offspring autism spectrum disorder risk was still increased in sensitivity analyses.

STILL TO COME

How it was doneWhat they found

Read the rest of this summary

You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.

Already have one?

What it does not show

This is an observational study, so it cannot prove that maternal rheumatoid arthritis caused autism in the children. The adjusted association in Cohort I was not statistically significant and had wide confidence intervals, while Cohort II and the pooled analysis were positive. Paternal rheumatoid arthritis was not measured, so family-level genetic or shared factors were not fully addressed. The study did not analyse seropositive versus seronegative rheumatoid arthritis because few seronegative cases were available. Medication use during pregnancy was not available, so treatment could confound the association. RA after delivery could include diagnoses made after the child received an autism diagnosis, which may bias the comparison. Some eligible studies were excluded for overlapping populations or missing adjusted estimates, and the meta-analysis used studies of varying quality.

Declared interests

The supplied metadata lists research support from NIH extramural and non-U.S. government sources. The article text does not provide a conflict-of-interest declaration.

The easy way to misread this

Do not tell a patient or family that maternal rheumatoid arthritis caused the child's autism. The study found an association, and the authors state that the associations do not necessarily imply causality.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →


The study

Participants
251,903 children in Cohort I and 309,696 children in Cohort II; the meta-analysis included estimates representative of 4,015,055 children
Certainty of evidence
Moderate

Browse

    Cite

    Evora Hailin Zhu, Benjamin Hk Yip, Caroline Fyfe, et al. Maternal rheumatoid arthritis and the risk of offspring autism spectrum disorder: two national birth cohorts and a meta-analysis. Molecular autism. 2025.

    Read the original — we summarise, we never replace the paper.