Maternal Autoimmune Disease and the Risk of Childhood Cancer Among the Offspring: A Population‐Based Cohort Study in Taiwan

Objectives Autoimmune diseases (ADs) are characterized by a loss of immune tolerance to self‐antigens. Maternal ADs are associated with pregnancy complications and are related to various diseases among their offspring. Existing studies have reported that maternal ADs increase the risk of certain types of malignancies in children. We aimed to investigate the association between maternal ADs and childhood cancer in Taiwan. Methods We established a population‐based cohort study using the Taiwan Maternal and Child Health Database, which links parents to their children, and connected it to the Taiwan Cancer Registry to identify cases of childhood cancer. Cox proportional hazard modeling was used to examine the association between maternal ADs and childhood cancer. Further analysis of exposure to overall maternal ADs and incident individual childhood cancer types was performed and stratified by child sex. Results From 2004 to 2015, there were a total of 2 385 071 live births in Taiwan; 97 138 were exposed to maternal ADs. Certain types of organ‐specific maternal ADs, including gastrointestinal and skin ADs, were weakly associated with overall childhood cancers. Compared to their counterparts, offspring exposed to maternal ADs were at risk of developing CNS tumors and neuroblastoma. Exposed female offspring had a higher risk of medulloblastoma and hepatoblastoma. Conclusion Our study implicates the association between maternal ADs and childhood cancer. Future research is required to elucidate the pathogenesis of the increased risk of childhood cancer among exposed offspring.