Neurodevelopment in children with and without congenital heart block born to anti-Ro/SSA-positive mothers.
OBJECTIVE
To define factors influencing neurodevelopment in children with and without complete congenital heart block (CHB) born to mothers with Ro/SSA autoantibodies.


METHODS
Medical records of a population-based cohort of siblings with (n = 60) and without (n = 54) CHB born 1974-2009 to anti-Ro/SSA-positive mothers were retrieved from children primary healthcare centres and school health services and used to extract data on neurodevelopment.


RESULTS
Impaired neurodevelopment was reported in 16% of the children (18/114) during the follow-up time of 13.0 (8.2-17.5) years, median (quartiles). Reported problems included speech (9%), motor (8%) and learning (8%) impairment, attention deficit (5%) and behavioural impairment (4%). Impairment in motor skill development was more common in boys (p < 0.001) if the child was born preterm (p < 0.001). Learning impairment was significantly influenced by maternal SLE (p < 0.005), while attention deficits was influenced by both maternal SLE (p < 0.05) and CHB in the child (p < 0.05).


CONCLUSIONS
Our data indicate that in addition to well-established factors such as male sex and being born preterm, both maternal SLE and CHB may influence neurodevelopment. Follow-up of neurodevelopment should therefore be considered for children with CHB, especially if the mother is diagnosed with SLE.
Department of Medicine, Rheumatology Unit, Karolinska Institutet, Stockholm, Sweden.
Amanda
A
Skog
Joanna
J
Tingström
Stina
S
Salomonsson
Sven-Erik
SE
Sonesson
Marie
M
Wahren-Herlenius
D001323:Autoantibodies; D002657:Child Development; D005260:Female; D006327:Heart Block / Q000151:congenital* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000276:immunology; D008297:Male; D009420:Nervous System / Q000254:growth & development*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology; D012189:Retrospective Studies; D012261:Ribonucleoproteins / Q000276:immunology; D000099207:SS-A Antigen
D001323:Autoantibodies; D012261:Ribonucleoproteins; D000099207:SS-A Antigen