Neurodevelopment in the offspring of Japanese systemic lupus erythematosus patients.
OBJECTIVE
To evaluate pregnancy outcome of systemic lupus erythematosus (SLE) and the neuropsychological outcomes in offspring of SLE mothers.


METHODS
Pregnancy outcomes of SLE patients from 1989 to 2006 were determined and the neuropsychological development of the children born to SLE patients was examined suited for their age; Bayley Scales of Infant Development up to four years and Kauffmann Assessment Battery for Children from four years onwards.


RESULTS
Of the 233 deliveries, 58 (24.7%) were preterm, 72 (30.9%) were low-birth-weight, and 46 (19.7%) were IUGR. Twenty-six children enrolled in this study had normal intelligence. The mean MDI and PDI were 95.8+/-10.1 and 94.6+/-14.1, respectively. The mean scores for the Sequential Processing scale, Simultaneous Processing scale, and Mental Processing composite were 103.1+/-13.3, 104.2+/-10.2, and 104.2+/-12.2, respectively. In the children with anti-Ro/SS-A antibody-positive mothers, mean gestational age and birth weight were significantly lower (p<0.05), as a result, the mean score of Sequential Processing and Mental Processing were significantly lower than that of negative mothers. The presence of maternal antiphospholipid antibody was not related to gestational age, birth weight and any score on the intelligence tests, except for the rate of IUGR.


CONCLUSIONS
The rates of preterm delivery and IUGR were frequent in the SLE patients and careful monitoring and management of the disease during pregnancy are still necessary. We should examine the neurodevelopment of the children born from mothers with anti-Ro/SS-A antibody prospectively.
Yoshikawa
Naomi
N
Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan. nao0213@gc5.so-net.ne.jp
Tanaka
Kyoko
K
Sekigawa
Mariko
M
Kudo
Noriko
N
Arai
Yayoi
Y
Ohtsuka
Yoshikazu
Y
Shimizu
Toshiaki
T
D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology; D044466:Asian People; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D005317:Fetal Growth Retardation; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000503:physiopathology*; D008297:Male; D009483:Neuropsychological Tests; D011247:Pregnancy / Q000276:immunology; D011248:Pregnancy Complications / Q000276:immunology; D011256:Pregnancy Outcome; D047928:Premature Birth
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C035356:SS-A antibodies