Long-term follow-up of offspring of mothers with systemic lupus erythematosus: an observational study.

PURPOSE: There is a scarcity of long-term follow-up studies on the offspring of mothers with systemic lupus erythematosus (SLE) in mainland China, due to the limited number of live births over the past decade. This study aims to report the long-term health of SLE offspring and the factors to affect health.

METHODS

This is an observational study of an ambispective cohort. We collected data through questionnaires and medical records. Peripheral venous blood samples were collected to test autoimmune parameters. The Wechsler Intelligence Scale was used to evaluate the neurological and psychiatric development. Children were born between August 1, 2007, and April 30, 2013, in Peking Union Medical College Hospital. Their mothers were diagnosed with SLE. Children were 12-16 years old during the follow-up period. We analyzed the occurrence rates of diseases and risk factors.

RESULTS

A total of 63 children were recruited. The ratio of males to females was 1.25:1, and 79.4% were born via cesarean sections. Preterm babies accounted for 25.4%. About 71.2% of them were fed with formula exclusively. The follow-up age was 13.1 ± 1.0 (12.0-16.9) years old. The occurrence rates of childhood-onset SLE, allergic diseases, attention-deficit hyperactivity disorder, and anxiety and depression were 3.2%, 39.7%, 4.8%, and 4.8% respectively. The proportion of allergic diseases is positively related (OR = 29.95, 95% CI 1.06-846.90) to the titers of anti-Sjögren's syndrome A (SSA) antibodies in mothers.

CONCLUSIONS

The probability of allergic diseases is positively related to the titers of anti-SSA in SLE mothers. SLE offspring have high proportions of childhood-onset SLE and allergic diseases. Key Points • The maternal disease of systemic lupus erythematosus (SLE) might affect the long-term health of their offspring, but there is little research data on their long-term complications in China. • Our hospital tried earlier to manage pregnant women with SLE in mainland China, with the earliest offspring having reached their adolescence. • Not counting children before adolescence as in previous studies, the long-term proportion of childhood-onset SLE is genuinely high. Meanwhile, the proportion of allergic disease is also higher than that of the general population. • The titer of maternal anti-SSA is positively associated with the risk of allergic diseases in offspring.