title: Children born to SLE and APS mothers.
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are autoimmune diseases that affect women of childbearing age. Pregnancies in these patients carry several complications such as prematurity. Maternal IgG antiphospholipid antibodies (aPL) can cross the placenta but they don't generally cause any neonatal thrombotic event. Because of the incompleteness of the fetal blood-brain barrier, aPL could theoretically reach the fetal brain. Whether this can have an effect on brain development is still under investigation. Some studies performed in children of patients with SLE and/or APS showed an increased number of learning disabilities without impairment in intelligence level.
  
  
  OBJECTIVE
  The objectives of this article are to evaluate the neurodevelopment outcome in 30 children (median age 9 years) born to mothers with SLE and/or APS with IgG anti-beta2-glycoprotein I during the third trimester of pregnancy and found positive for the same antibodies at birth.
  
  
  METHODS
  A neurological physical exam was performed in all children. We submitted some questionnaires to the mothers: the Child Behavior CheckList (CBCL) and a homemade set of questions obtained by a team composed of rheumatologists and pediatric neurologists. Intellectual functioning was determined by the Wechsler scale for corrected age.
  
  
  RESULTS
  In all children neurological physical exam and intelligence levels were found to be normal but mild behavior disorders and history of neurological manifestations were shown in three children.
  
  
  CONCLUSIONS
  Offspring of patients with SLE and/or APS are generally healthy. We and others observed the occurrence of minor neurological disorders that might be related to maternal disease or to prematurity. The limited number of the available data on this sensitive issue supports the need for further studies.
authors.affiliation: Rheumatology and Clinical Immunology.
authors.forename: C
authors.initials: C
authors.lastname: Nalli
authors.affiliation: Unit of Child and Adolescent Neuropsychiatry.
authors.forename: A
authors.initials: A
authors.lastname: Iodice
authors.affiliation: Rheumatology and Clinical Immunology.
authors.forename: L
authors.initials: L
authors.lastname: Andreoli
authors.affiliation: Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lojacono
authors.affiliation: Neonatology and NICU, Spedali Civili, Brescia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Motta
authors.affiliation: Unit of Child and Adolescent Neuropsychiatry.
authors.forename: E
authors.initials: E
authors.lastname: Fazzi
authors.affiliation: Rheumatology and Clinical Immunology tincani@bresciareumatologia.it.
authors.forename: A
authors.initials: A
authors.lastname: Tincani
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications*; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology; D002657:Child Development; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Systemic lupus erythematosus (SLE); antiphospholipid syndrome (APS); behavioral disorders; children’s outcome; learning disabilities