The development of offspring from mothers with systemic lupus erythematosus. A systematic review

Fjodor A Yousef Yengej; Annet van Royen-Kerkhof; Ronald H W M Derksen; Ruth D E Fritsch-Stork

doi:10.1016/j.autrev.2017.05.005

The development of offspring from mothers with systemic lupus erythematosus. A systematic review

Autoimmun Rev. 2017 Jul;16(7):701-711. doi: 10.1016/j.autrev.2017.05.005. Epub 2017 May 4.

Authors

Fjodor A Yousef Yengej¹, Annet van Royen-Kerkhof², Ronald H W M Derksen¹, Ruth D E Fritsch-Stork³

Affiliations

¹ Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
² Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.
³ Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands; 1st Medical Department, Hanusch Hospital of WGKK, Vienna, Austria; Sigmund Freud University, Vienna, Austria; Ludwig Boltzmann Institute of Osteology, Hanusch Hosptial and AUVA Trauma Centre Meidling, Vienna, Austria. Electronic address: r.fritsch@umcutrecht.nl.

PMID: 28479488
DOI: 10.1016/j.autrev.2017.05.005

Abstract

Objective: To analyze published data on the influence of maternal systemic lupus erythematosus (SLE) on different aspects of child development.

Methods: A systematic review was conducted using PubMed and Embase searches for SLE or SLE-related antibodies and physical, neurocognitive, psychiatric or motor development outcomes in children.

Results: In total 24 cohort and 4 case-control studies were included after initial screening of 1853 hits. Learning disorders (LD) were reported in 21.4-26% of SLE offspring, exceeding the prevalence in the general population. Four studies reported that dyslexia and reading problems were present in 14.3-21.6% of lupus offspring with a clear male predominance. Furthermore, a twofold increased rate of autism spectrum disorders (ASD) (n=1 study) and a two- to threefold increased risk for speech disorders (n=3 studies) were reported in lupus offspring compared to controls, although the latter was not statistically significant. More divergent results were found for attention deficit (n=5 studies) and behavior disorders (n=3 studies). In two large controlled studies attention disorders were more prevalent and a trend towards more behavior disorders was reported in 2 of 3 studies analyzing this subject. Finally, IQ and motor skills were not affected in respectively 7 and 5 studies. Cardiopulmonary functioning and mood disorders were scarcely investigated (both n=1). Maternal anti-SSA antibodies were associated with LD in offspring in one study. Other SLE-related antibodies were rarely studied.

Conclusion: This systematic review suggests that maternal SLE is associated with LD (specifically dyslexia), ASD, attention deficit and probably speech problems in offspring. However, over half of the studies were assigned a low or moderate evidence level. Therefore, further research is necessary to substantiate the found evidence and expand the scope to lesser researched areas such as cardiopulmonary functioning.

Keywords: Antibodies; Development; Offspring; Pregnancy; Systemic lupus erythematosus.

Publication types

Review
Systematic Review

MeSH terms

Animals
Attention Deficit Disorder with Hyperactivity / epidemiology
Attention Deficit Disorder with Hyperactivity / etiology*
Autism Spectrum Disorder / epidemiology
Autism Spectrum Disorder / etiology*
Female
Humans
Learning Disabilities / epidemiology
Learning Disabilities / etiology*
Lupus Erythematosus, Systemic / complications*
Lupus Erythematosus, Systemic / epidemiology
Mothers
Speech Disorders / epidemiology
Speech Disorders / etiology*