FRI0373 Long-term follow-up of 320 children born to mothers with systemic autoimmune diseases: a multicentre italian survey from 24 rheumatology centres

Abstract

BackgroundRheumatic Diseases (RD) frequently affect women during reproductive age, therefore counselling on family planning is crucial for their quality of life. Children’s outcome is a major topic, but no large studies are available.ObjectivesTo assess the long-term health conditions of children born to women with RD in a large multicentre cohort.Methods24 Rheumatology Centres distributed the questionnaire (65 multiple-choice and 12 open-answer questions) to consecutive patients (18–55 years) in September 2015. Data were analysed dividing children upon maternal diagnosis: Chronic Arthritides (CA) and Connective Tissue Diseases (CTD).ResultsData were collected for 320 children (166 males, 52%) born to 184 mothers (63 CA and 121 CTD). At the time of interview, children had a mean age of 17.1±9.6 years. Preterm delivery (<37 w) was observed in 72 cases (22.5%), including 13 (4%)<34 w. Data on autoimmune/inflammatory disease (AIID) and/or neurodevelopmental disorders (ND)/learning disabilities (LD) is reported in table 1. 12 children (3.7%) had a diagnosis of AIID, mostly coeliac disease (8/12, 67%)and 11 children (3.4%) of a ND and/or LD by a Paediatric Neuropsychiatrist. To rule out the possible effects of in utero exposure to maternal autoantibodies and/or anti-rheumatic drugs in the pathogenesis of ND, these data were retrieved for 280 children (88%) and a comparison was performed between 11 affected and 269 not-affected children (table 2).Abstract FRI0373 – Table 1DM: diabetes mellitus; LD: learning disorder; ADHD: attention deficit hyperactivity disorderAbstract FRI0373 – Table 2ConclusionsIn this long-term follow-up of children born to mothers with RD in this large, multicenter study of randomly interviewed women each AIID did not display a significantly increased frequency as compared to the literature; only coeliac showed a mild increased frequency. Children with LD had a tendency to cluster in the group of mothers with CTD, especially after maternal diagnosis (4/63, 6.3%), with a higher frequency as compared to general paediatric population. No significant relationships between ND/LD and prematurity, intrauterine drug exposure or maternal autoantibodies were identified.AcknowledgementsStatistical analysis supported by an unrestricted grant by UCB Pharma. The authors wish to thank Patients Associations and Participants to the survey.Disclosure of InterestNone declared

Neuropsychiatric Outcome of Children Born to Women With Systemic Lupus Erythematosus and Exposed in Utero to Azathioprine: A Case-Control Study

“…A diagnosis of LD was present in 19% of school-aged children, all born to mothers with positive aPL with three positive tests (triple aPL profile); none of seven children exposed in utero to AZA had ND or LD. Moreover, in a recent multicentre Italian survey involving women in reproductive age with different rheumatic diseases, no association was found between the reported presence of children NPD and in utero exposure to maternal auto-antibodies or drugs, including AZA (Lazzaroni et al, 2017). 2 | Univariate analysis of the case-control study comparing the outcome of children born to SLE pregnancies included in the study and exposed in utero to AZA (n children 27) vs. not-exposed in utero to AZA (n children 65).…”

“APS pregnancy – The offspring”

“…The common experience is that children born to mothers with rheumatic diseases generally have uncomplicated growth, are healthy, display a normal intelligence level, and do not show any significantly increased risk of developing an autoimmune disease. 65 However, clinical follow-up of children of mothers with APS seems to be important to exclude, in the neonatal period, the occurrence of aPL associated pathological events such as thrombosis. In the long-term, it would ideally include evaluation by specialists in child neurology and psychiatry during primary school, mainly because impairment in learning skills or behavioral problems may appear and become evident at this age, and a proper diagnosis and management can provide an important help.…”