title: Bone status of children born from mothers with autoimmune diseases treated during pregnancy with prednisone and/or low molecular weight heparin.
abstract: BACKGROUND
  To evaluate bone status in children born from mothers followed for autoimmune diseases and treated during pregnancy with low molecular weight heparin (LMVH) and/or prednisone.
  
  
  RESULTS
  History, physical examination, laboratory tests and phalangeal ultrasonography were performed. Demographic, clinical, and laboratory data were entered into a customized database, and results were analyzed with SPSS software. In children whose mothers were treated with LMWH, we retrieved dried blood spots taken for newborn screening, and analyzed the presence of heparin with tandem mass spectrometry. We enrolled 27 females and 14 males born from 31 mothers with SLE or connective tissue diseases. These women were continuously treated during pregnancy with LMWH (n = 10), prednisone (n = 16), or both (n = 15). Bone ultrasound revealed low values (≤ 3 centile for age) in ten patients. In a multistep regression analysis, age at examination resulted the single predictor of low ultrasound values (p < 0.004). Tandem mass spectroscopy failed to determine traces of heparin in newborn blood.
  
  
  CONCLUSIONS
  Children born from mothers with autoimmune diseases are at risk to develop reduced bone mass. The administration of LMWH and of prednisone seems to be safe with regard to children's bone health.
authors.affiliation: Department of Pediatrics, University of Florence, AOU Meyer, Rheumatology Unit, Viale Pieraccini 24, 50139 Florence, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pagnini
authors.affiliation: Department of Pediatrics, University of Florence, AOU Meyer, Rheumatology Unit, Viale Pieraccini 24, 50139 Florence, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simonini
authors.affiliation: Department of Endocrinology, University of Florence, Florence, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Cavalli
authors.affiliation: Department of Pediatrics, University of Florence, AOU Meyer, Rheumatology Unit, Viale Pieraccini 24, 50139 Florence, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: la Marca
authors.affiliation: Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iuliano
authors.affiliation: Department of Endocrinology, University of Florence, Florence, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Brandi
authors.affiliation: Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bellisai
authors.affiliation: Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Frediani
authors.affiliation: Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.affiliation: Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
authors.affiliation: Department of Pediatrics, University of Florence, AOU Meyer, Rheumatology Unit, Viale Pieraccini 24, 50139 Florence, Italy.
authors.forename: Rolando
authors.initials: R
authors.lastname: Cimaz
mesh_terms: D001327:Autoimmune Diseases / Q000188:drug therapy*; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003240:Connective Tissue Diseases / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D008297:Male; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects / Q000000981:diagnostic imaging / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D006495:Heparin, Low-Molecular-Weight; D011241:Prednisone
keywords: Autoimmune diseases; Corticosteroids; Heparin; Osteoporosis; Pregnancy