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Published on: March 25, 2016
Neurocognitive abnormalities in offspring of mothers with systemic lupus erythematosus
M B Urowitz1, D D Gladman, A MacKinnon
1Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, University of Toronto Lupus Clinic, Toronto, Ontario, Canada. m.urowitz@utoronto.ca
Insights
Children born to mothers with systemic lupus erythematosus (SLE) showed cognitive impairments in learning, memory, and behavior compared to healthy controls. This study assessed neurodevelopmental outcomes in SLE offspring.
Area of Science:
- Pediatric Rheumatology
- Neuropsychology
- Genetics and Epidemiology
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems.
- Maternal autoimmune diseases, including SLE, have been associated with potential neurodevelopmental effects in offspring.
- Longitudinal assessment of neurocognitive outcomes in children of SLE patients is crucial for understanding disease impact.
Purpose of the Study:
- To evaluate the neurocognitive development of children born to mothers with SLE.
- To compare the neurodevelopmental profiles of SLE offspring with age, sex, race, and socio-economic status-matched controls.
- To identify specific domains of neurocognitive function that may be affected in offspring of SLE patients.
Main Methods:
- Prospective cohort study involving 106 children (57 SLE offspring and 49 matched controls).
- Neurocognitive assessments across nine domains were performed using age-appropriate tests.
- Statistical analyses included McNemar tests, chi-square tests, and logistic regression to compare SLE offspring and controls.
Main Results:
- No SLE offspring were diagnosed with SLE.
- Matched analyses revealed significant impairments in SLE children compared to controls in two domains: learning and memory, and behavior.
- No significant differences were found in the other seven neurocognitive domains evaluated.
Conclusions:
- Offspring of mothers with SLE exhibit specific neurocognitive deficits, particularly in learning, memory, and behavior.
- These findings highlight the importance of monitoring neurodevelopmental outcomes in children with maternal SLE.
- Further research is warranted to elucidate the mechanisms underlying these observed neurocognitive differences.
Abstract:
Offspring of systemic lupus erythematosus (SLE) patients delivered during follow-up in the lupus clinic from 1973 to 1998 were assessed for SLE and by age-appropriate neurocognitive tests. Nine domains were evaluated. Controls, matched for age, sex, race and socio-economic status, underwent the same neurodevelopmental/neuropsychological evaluation. A domain was considered 'abnormal' if at least one of the tests in the domain yielded abnormal results. The number of offspring with normal/abnormal results was compared in each of the nine domains using McNemar test for matched analysis. In addition, an unmatched analysis using chi-square tests was performed. Logistic regression was run on both the matched pairs and unmatched groups to adjust for possible gender differences. A total of 106 children, 49 pairs of SLE offspring and matched controls (20 male and 29 female) and an extra eight offspring (three male and five female) of SLE patients without a control match were included. Of the 57 SLE offspring, none were diagnosed with SLE. The matched analyses of the neuropsychological domains revealed impairment in SLE children compared with matched controls in two of the nine domains: learning and memory and behaviour.
