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Environmental Risk Factors and Early‐Life Exposures in Juvenile Idiopathic Arthritis: A Case–Control Study
Author(s) -
Shenoi S.,
Shaffer M. L.,
Wallace C. A.
Publication year - 2016
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22806
Subject(s) - medicine , breastfeeding , odds ratio , socioeconomic status , case control study , confidence interval , etiology , arthritis , pediatrics , environmental health , demography , population , sociology
Objective Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders characterized by chronic arthritis in children with unknown etiology. Although research evaluating environmental or early‐life exposures in JIA is scarce, there are data to suggest that infections, smoking exposure, and lack of breastfeeding play a role. This case–control study investigated the association of selected environmental and early‐life risk factors with the development of JIA. Methods JIA cases were identified at a major pediatric rheumatology outpatient clinic. Each case was asked to identify up to 3 healthy playmates of similar age and same sex to serve as controls. Parents/caregivers of cases and controls completed a questionnaire on selected environmental and early‐life exposures. Conditional logistic regression adjusted for age and socioeconomic status was used to determine the odds ratio (OR) for developing JIA with 95% confidence intervals (95% CIs) for the playmate‐matched design. Results Included in the study were 225 JIA cases and 138 controls. Compared to playmate‐matched controls, preterm delivery (OR 1.8 [95% CI 1.2–2.7]) was associated with JIA. There was no association between JIA and household smoking or maternal prenatal smoking, breastfeeding, hospitalization with infection in the first year of life, daycare attendance before 6 years of age, household pets, or residential area prior to the onset of JIA. Conclusion There was no association between the previously reported risk factors of smoking, early‐life infection, or breastfeeding and development of JIA in this study. The association of preterm delivery with JIA needs to be further studied.