Maternal autoimmune diseases (AIDs) have been associated with adverse perinatal outcomes, raising questions about potential long-term cardiovascular implications for offspring. A nationwide population-based cohort study, published in the European Heart Journal, included 1,455,645 live singleton births in Sweden between 2001 and 2014, with follow-up through December 31, 2023.

The study assessed whether intrauterine exposure to maternal AIDs was associated with cardiovascular disease (CVD) risk in offspring from childhood to early adulthood. Cox proportional hazards models were used to estimate associations. Additional analyses, including cousin comparisons and paternal AID exposure, were conducted to evaluate potential familial and genetic confounding.

During a median follow-up of 15.2 years (range 0–23.7 years), 90,046 individuals (6.2%) were exposed to maternal AIDs, and 40,260 (2.8%) developed CVD. Exposure to maternal AIDs was associated with an increased risk of any CVD in offspring (hazard ratio [HR] 1.19; 95% confidence interval [CI] 1.14–1.24).

Elevated risks were observed across different maternal AID categories. Associations between paternal AIDs and offspring CVD were weaker than those observed for maternal AIDs. In cousin analyses, the association between maternal AIDs and offspring CVD persisted, although effect estimates were attenuated compared with the primary analyses.

Intrauterine exposure to maternal AIDs was associated with a modest increase in offspring CVD risk. Shared familial and genetic factors may partly explain the observed associations.