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Higher risk of autoimmune disorders in children of mothers with Alopecia Areata

A new study from Korea has determined that children of mothers with alopecia areata (AA) appear to be at higher risk of developing autoimmune/inflammatory, atopic, thyroid, and psychiatric disorders.

Published in JAMA Dermatology, this retrospective population-based birth cohort study analyzed 67,364 offspring born to 46,352 mothers with AA and 673,640 controls born to 454,085 unaffected mothers. The analysis was conducted from July 2022 to Jan. 2023.

Using the linked birth registration database with the Nationwide Health Insurance Service database of Korea, the participants included all newborns born to mothers with three or more visits with International Classification of Diseases, Tenth Revision code of L63 and 1:10 birth year, sex, insurance, income, and location of residence–matched control offspring born to mothers without AA during the years from 2003 to 2015. The children were analyzed from birth to Dec. 31, 2020.

The researchers evaluated the children for these diseases: alopecia totalis/universalis (AT/AU), vitiligo, psoriasis, inflammatory bowel disease, rheumatoid arthritis, atopic dermatitis, allergic rhinitis, asthma, hyperthyroidism, hypothyroidism, Graves disease, Hashimoto thyroiditis, attention-deficit hyperactivity disorder, mood disorder, and anxiety disorder. Multivariable Cox proportional hazard analyses were performed using the covariates of birth year, age, insurance type, income level, location of residence, maternal age, mode of delivery, maternal history of atopic disorders, and autoimmune disorders.

They found the risk of AA (adjusted hazard ratio [aHR], 2.08; 95% CI, 1.88-2.30), AT/AU (aHR, 1.57; 95% CI, 1.18-2.08), vitiligo (aHR, 1.47; 95% CI, 1.32-1.63), atopic disorders (aHR, 1.07; 95% CI, 1.06-1.09), hypothyroidism (aHR, 1.14; 95% CI, 1.03-1.25), and psychiatric disorders (aHR, 1.15; 95% CI, 1.11-1.20) was significantly increased in offspring born to mothers with AA. The 5,088 children born to mothers with AT/AU were at much greater risk for the development of AT/AU (aHR, 2.98; 95% CI, 1.48-6.00) and psychiatric disorders (aHR, 1.27; 95% CI, 1.12-1.44).

“Several studies have reported maternal autoimmunity and the development of autoimmune and inflammatory disorders in offspring, but studies on [alopecia areata (AA)] are rare,” Ju Yeong Lee, MD, of the Department of Dermatology at Yonsei University Wonju College of Medicine in Wonju, Korea, and colleagues wrote in the paper.

Clinicians and parents need to be aware of the potential for these comorbidities to occur.”


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