EULAR Annual Congress
EULAR Annual Congress
June 18, 2015
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Children born to mothers with antiphospholipid antibodies may have neurologic problems, epilepsy

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Children born to mothers with antiphospholipid antibodies appear to be more likely to have neurological manifestations or epilepsy, according to study findings presented at the European League Against Rheumatism Annual European Congress of Rheumatology.

Researchers studied 40 children (mean age: 7.4 years; 21 boys) born to 32 women with systemic autoimmune disease and antiphospholipid antibodies (aPL) present during the third trimester of pregnancy. Triple aPL positivity was seen in 21 mothers (53%), double positivity was seen in 11 mothers (30%) and single positivity was seen in eight mothers (16%). Anti-dsDNA antibodies were present in 11 of 16 patients with systemic lupus erythematosus (SLE), but anti-Ro antibodies were not.

A pediatric neurologist evaluated all of the children. The Child Behavior Checklist was administered to the mothers in addition to a questionnaire developed to focus on the mothers’ use of drugs during pregnancy and the Developmental Neuropsychological Assessment (NEPSY-II) of the children, when indicated. Characteristics such as gestational age, infant milestones and scholastic performance were also collected.

Results showed all of the children displayed normal neurological physical exam results and intelligence levels upon evaluation. Mild problems were observed in 13 of the children, and in 11 children, the researchers found discrepant cognitive profiles, with either a reduced verbal intelligence quotient or performance intelligence quotient, and sleep disorders. The NEPSY-II was performed in these children, and pathological results were seen in two children in one or more of the areas examined. Both children were born preterm, and both were diagnosed with learning disabilities; one of the children was born to a mother with SLE who anti-dsDNA-negative and single-positive for aPL. The other mother was triple-positive for aPL.

Four children had history of seizures, two of whom had reduced verbal or performance intelligence. One child had neonatal stroke and was born preterm. Four children (10%) had epilepsy, a rate about 20-times higher than the general population, according to the researchers.

“It is difficult to say if these findings are due to prematurity, to maternal disease or to environmental factors because we could not find a significant relationship with any of the investigated variables,” the researchers wrote. “However, our results underline the importance of a careful follow-up of children born to patients with aPL in order to support the needs of a growing child.” – by Shirley Pulawski

Reference:

Nalli C, et al. Paper #AB0557. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.