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Long-Term Outcomes of Children Born to Anti-Ro Antibody-Positive Mothers With and Without Rheumatic Disease
Talia Diaz1, Ashely Danguecan2, Daniela Dominguez3
1The Hospital for Sick Children, Toronto, Ontario, Canada, and Hospital San José, Tecnológico de Monterrey, Monterrey, Nuevo Leon, Mexico.
Insights
Children born to anti-Ro antibody-positive mothers do not have a higher prevalence of allergy, neurodevelopmental, or autoimmune diseases. This finding applies whether or not the child has neonatal lupus erythematosus (NLE) or if the mother has a rheumatic disease.
Area of Science:
- Pediatric Autoimmunity
- Neonatal Immunology
- Developmental Pediatrics
Background:
- Maternal autoantibodies, such as anti-Ro, can cross the placenta, potentially impacting fetal development.
- Neonatal Lupus Erythematosus (NLE) is a known complication in infants born to anti-Ro antibody-positive mothers.
- The long-term health outcomes, specifically allergic, neurodevelopmental, and autoimmune diagnoses, in these children require further investigation.
Purpose of the Study:
- To estimate the prevalence of allergy, neurodevelopmental, and autoimmune diagnoses in children born to anti-Ro antibody-positive mothers.
- To compare disease prevalence between children with and without NLE manifestations.
- To compare disease prevalence between children born to mothers with and without rheumatic disease.
Main Methods:
- A cohort study was conducted with children born to anti-Ro antibody-positive mothers.
- Participants aged one year or older completed a health status questionnaire.
- Prevalence of allergic, neurodevelopmental, and autoimmune diagnoses were compared between the NLE cohort and the population-based CHILD Cohort Study.
Main Results:
- No significant difference in disease prevalence was found between children with and without NLE manifestations (P=0.57).
- Disease prevalence was similar between children born to mothers with and without rheumatic disease (P=0.11).
- Allergic disease (30% vs 22%), neurodevelopmental conditions (5% vs 2%), and autoimmune disease (4% vs 2%) prevalence were comparable between the NLE and CHILD cohorts.
Conclusions:
- Infants born to anti-Ro antibody-positive mothers do not exhibit a higher prevalence of allergic, neurodevelopmental, or autoimmune diseases.
- The presence of NLE or maternal rheumatic disease did not significantly alter the observed disease prevalence in offspring.
- Findings suggest that anti-Ro antibody positivity alone, without NLE, may not confer an increased risk for these specific childhood conditions.
Objective:
The objective of this study was to estimate the prevalence of allergy, and/or neurodevelopmental and autoimmune diagnoses in children born to anti-Ro antibody-positive mothers.
Methods:
We conducted a cohort study of children born to anti-Ro antibody-positive mothers observed in the neonatal lupus erythematosus (NLE) clinic at The Hospital for Sick Children. Participants one year of age or older were invited to complete a health status questionnaire. Prevalence of allergic, neurodevelopmental, and autoimmune disease diagnoses was compared between the NLE cohort and the non-NLE population-based CHILD Cohort Study cohort. Descriptive statistics were used for demographics, NLE manifestations, and outcomes. Fisher's exact test compared the prevalence of diagnoses between subgroups. We tested the association between allergies and neurodevelopmental conditions and NLE with logistic regression models. A P-value < 0.006 was considered significant.
Results:
We included 321 participants born to anti-Ro antibody-positive mothers. The median age at survey completion was six years, 51% of participants were female, and 50% (n = 162) had NLE. We found no significant difference in any disease prevalence between children with and without NLE manifestations (P = 0.57) or between children born to mothers with and without a rheumatic disease (P = 0.11). Disease prevalence was similar between the NLE and CHILD cohorts (allergic disease 30% vs 22% [P= 0.25], neurodevelopmental conditions 5% vs 2% [P = 0.45], autoimmune disease 4% vs 2% [P = 0.68]).
Conclusion:
In a large multiethnic cohort of infants born to anti-Ro antibody-positive mothers, there was no significant difference in the prevalence of allergic, neurodevelopmental, or autoimmune diseases between children with and without NLE or between those born to anti-Ro antibody-positive mothers and a population-based non-NLE cohort.
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