Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Outcome of Babies Born to Mothers with Systemic Auto-Immune Diseases.

Abisror1,  Noemie, Mekinian1,  Arsene, Lachassinne2,  Eric, nicaise-Roland3,  Pascale, Stirnemann4,  Jerome, de Pontual*2,  Loic, Carbillon5,  Lionel

Jean Verdier Hospital, Bondy, France
Service de néonatologie et pédiatrie, Université Paris 13, AP-HP, Hôpital Jean Verdier, 93140, Bondy, France, Bondy, France
Unité Fonctionnelles d'Immunologie «Autoimmunité et Hypersensibilités>>, AP-HP, Hôpital Bichat-Claude Bernard, Paris, Paris, France
Service de médecine interne, Université Paris 13, AP-HP, Hôpital Jean Verdier, 93140, Bondy, France, Bondy, France
Service de gynécologie-obstétrique, Université Paris 13, AP-HP, Hôpital Jean Verdier, 93140, Bondy, France, Bondy, France

Background/Purpose:

To evaluate the neonatal complications, the long-term outcome and the immunological profile of babies born to mothers with primary antiphospholipid syndrome and lupus erythematosus.

Methods:

Retrospective study from 2003 to 2010, assessing the clinical characteristics and psychomotor development, as well as biological data of children born to mothers with antiphospholipid syndrome (APS) (Group 1) and systemic lupus erythematosus (Group 2).

Results:

Group 1 consisted of 45 children born to mothers (n=35) with a primary APS (median age 33 years [27–44]). The treatments during pregnancy were aspirin 100 mg (n = 31) and low-molecular weight heparin (LMWH) (n=35). Premature term < 37 weeks was present in 6 cases (13%). The median weight at birth was 3000 grams [920–4100], and 8 children had a weight < 2500 grams (18%) (table). The median follow-up was 11 months [1–72]. Since no thrombosis, or lupus were noted, an abnormal psychomotor development occurred in 5 cases [motor distal disorders (n=2) and autism (n =3)], associated with a language delay in 5 cases (11%). Three children with autism had persistent antibéta2GP1 IgG antibodies.

 APS group children (n=45)Lupus group children (n=13)
Term38 [32–41]38 [37–41]
Term <37 weeks6 (13%)0
Birth weight (g)3000 [920–4110]3000 [2500–4000]
Birth height (cm)49 [37–58]49 [44–52]
Birth cranial perimeter (cm)34 [30–39]34 [32–50]
Apgar 1/5 minutes10 [9–10]/10 [5–10]10 [9–10]/10 [10]
Birth weight<2500 g7 (18%)0
Psychomotor development trouble5 (13%)0
Neonatal lupus03 (23%)*
Follow-up (months)11 [1–72]9 [3–48]
Antinuclear antibodies0 [0–80]320 [0–1280]*
Anti-SSA antibodies04 (31%)
*p<0.05

Group 2 consisted of 13 children born to mothers with systemic lupus (n=10) (median age 37 ([31–42]).) During pregnancy, treatments were aspirin 100 mg in association with low-molecular weight heparin (n = 6), hydroxychloroquine (n=8) and corticosteroids (n=8). Median birth weight was 3000 grams [2500–4000], and no preterm birth or weight<2500 g were noted (table). During follow-up of 9 months [3–48], three children experienced cutaneous neonatal lupus, but there were no thrombosis, or psychomotor development abnormalities. Antinuclear antibodies were present in 8 children (320 UI [0–1280]), and anti-SSA antibodies in 4 cases. Significant correlation was noted between antinuclear antibodies in mothers and children of group 2 (r =0.9; p = 0.01).

Comparing the characteristics of group 1 and 2, no significant difference was found with regard to the parameters at birth, during the follow-up or the presence of antiphospholipid antibodies. The children in Group 2 had more frequently antinuclear antibodies (p < 0.05), with median titers 320 UI [0–1280] in group 2 versus 0 [0–80] in group 1 (p = 0.0002).

Conclusion:

Despite a significant rate of premature birth in babies born to mothers with APS, it does not seem to be increase of psychomotor development abnormalities. Nevertheless the presence of 3 cases of autism and of disorders in language acquisition should be analysed in a study with a control group. The presence of anti-nuclear antibodies and neonatal lupus is more common in children born to mothers with lupus, inversely of children from APS mothers, in concern to antiphospholipid antibodies and thrombosis.

To cite this abstract, please use the following information:
Abisror, Noemie, Mekinian, Arsene, Lachassinne, Eric, nicaise-Roland, Pascale, Stirnemann, Jerome, de Pontual*, Loic, et al; Outcome of Babies Born to Mothers with Systemic Auto-Immune Diseases. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2035
DOI:

Abstract Supplement

Meeting Menu

2011 ACR/ARHP