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Reproductive health and APS
Increased usage of special educational services by children born to mothers with systemic lupus erythematosus and antiphospholipid antibodies
  1. Wendy Marder1,2,
  2. Vivian C Romero2,
  3. Martha A Ganser1,
  4. Margaret A Hyzy1,
  5. Caroline Gordon3,
  6. W J McCune1 and
  7. Emily C Somers1,2,4
  1. 1Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Michigan, Ann Arbor, Michigan, USA
  3. 3School of Immunity and Infection, University of Birmingham, Birmingham, UK
  4. 4Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Wendy Marder, wmarder{at}umich.edu

Abstract

Introduction Surveys of long-term health and developmental outcomes of children born to mothers with systemic lupus erythematosus (SLE) have suggested an increase in learning disabilities among these children. We performed this observational study to investigate the relationship between maternal autoantibodies and antiphospholipid antibody syndrome (APS) in maternal lupus patients and neurocognitive development among their offspring.

Methods SLE mothers with at least one live birth postlupus diagnosis were enrolled. Data on maternal medical/obstetric history and children's perinatal/medical history were collected by structured interview and medical record reviews. The primary outcome was requirement for special educational (SE) services, a proxy for developmental delays. Multiple logistic regression modelling was used to examine associations between APS and autoantibodies with SE usage, accounting for SLE disease severity and potential confounders.

Results Data on 38 mothers and 60 offspring were analysed: SE service usage was reported for 15 of 60 (25%) offspring. Maternal APS history was significantly associated with increased use of SE services among offspring, including after adjustment for lupus anticoagulant (LA) positivity and potential confounders (OR 5.5–9.4 for delays age ≥2; p<0.05). The presence of LA, but not other antiphospholipid antibodies, was also associated with increased SE services usage.

Conclusions Maternal APS and LA were independently associated with increased usage of special educational services among offspring of women with SLE.

  • Antiphospholipid Antibodies
  • Antiphospholipid Syndrome
  • Autoantibodies
  • Outcomes research
  • Systemic Lupus Erythematosus

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/lupus-2014-000034

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