title: Increased congenital heart defects in children born to women with systemic lupus erythematosus: results from the offspring of Systemic Lupus Erythematosus Mothers Registry Study.
abstract: BACKGROUND
  In a large population-based study, we aimed to determine whether children born to women with systemic lupus erythematosus (SLE) have an increased risk of congenital heart defects (CHDs) in comparison with children born to women without SLE.
  
  
  RESULTS
  The Offspring of SLE Mothers Registry (OSLER) includes all women who had ≥1 hospitalization for delivery after SLE diagnosis, identified through Quebec's healthcare databases (1989-2009), and a randomly selected control group of women, matched ≥4:1 for age and year of delivery. We identified children born live to SLE mothers and their matched controls, and ascertained CHD based on ≥1 hospitalization or physician visit with relevant diagnostic codes, within the first 12 months of life. We performed multivariable logistic regression analyses, using the generalized estimating equation method, to adjust for relevant covariates. Five hundred nine women with SLE had 719 children, whereas 5824 matched controls had 8493 children. In comparison with controls, children born to women with SLE experienced more CHD (5.2% [95% confidence interval (CI), 3.7-7.1] versus 1.9% [95% CI, 1.6-2.2], difference 3.3% [95% CI, 1.9-5.2]). In multivariable analyses, children born to women with SLE had a substantially increased risk of CHD (odds ratio, 2.62; 95% CI, 1.77-3.88) in comparison with controls. In addition, in comparison with controls, offspring of SLE mothers had a substantially increased risk of having a CHD repair procedure (odds ratio, 5.82; 95% CI, 1.77-19.09).
  
  
  CONCLUSIONS
  In comparison with children from the general population, children born to women with SLE have an increased risk of CHD, and an increased risk of having a CHD repair procedure, as well.
authors.affiliation: From the Division of Clinical Epidemiology (E.V., S.S., A.E.C., S.B.), Division of Rheumatology (E.V., C.A.P., S.B.), McGill University Health Centre, Montreal, Canada; Division of Rheumatology, University of Calgary, Calgary, Canada (A.E.C.); and Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada (R.W.P.). evelyne.vinet@mail.mcgill.ca.
authors.forename: Évelyne
authors.initials: É
authors.lastname: Vinet
authors.affiliation: From the Division of Clinical Epidemiology (E.V., S.S., A.E.C., S.B.), Division of Rheumatology (E.V., C.A.P., S.B.), McGill University Health Centre, Montreal, Canada; Division of Rheumatology, University of Calgary, Calgary, Canada (A.E.C.); and Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada (R.W.P.).
authors.forename: Christian A
authors.initials: CA
authors.lastname: Pineau
authors.affiliation: From the Division of Clinical Epidemiology (E.V., S.S., A.E.C., S.B.), Division of Rheumatology (E.V., C.A.P., S.B.), McGill University Health Centre, Montreal, Canada; Division of Rheumatology, University of Calgary, Calgary, Canada (A.E.C.); and Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada (R.W.P.).
authors.forename: Susan
authors.initials: S
authors.lastname: Scott
authors.affiliation: From the Division of Clinical Epidemiology (E.V., S.S., A.E.C., S.B.), Division of Rheumatology (E.V., C.A.P., S.B.), McGill University Health Centre, Montreal, Canada; Division of Rheumatology, University of Calgary, Calgary, Canada (A.E.C.); and Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada (R.W.P.).
authors.forename: Ann E
authors.initials: AE
authors.lastname: Clarke
authors.affiliation: From the Division of Clinical Epidemiology (E.V., S.S., A.E.C., S.B.), Division of Rheumatology (E.V., C.A.P., S.B.), McGill University Health Centre, Montreal, Canada; Division of Rheumatology, University of Calgary, Calgary, Canada (A.E.C.); and Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada (R.W.P.).
authors.forename: Robert W
authors.initials: RW
authors.lastname: Platt
authors.affiliation: From the Division of Clinical Epidemiology (E.V., S.S., A.E.C., S.B.), Division of Rheumatology (E.V., C.A.P., S.B.), McGill University Health Centre, Montreal, Canada; Division of Rheumatology, University of Calgary, Calgary, Canada (A.E.C.); and Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada (R.W.P.).
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011792:Quebec / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D016216:Ultrasonography, Prenatal
chemical_list: D000305:Adrenal Cortex Hormones; D000962:Antimalarials; D007166:Immunosuppressive Agents
keywords: epidemiology; heart defects, congenital; lupus erythematosus, systemic; pregnancy