TY - JOUR
T1 - The development of offspring from mothers with systemic lupus erythematosus. A systematic review
AU - Yousef Yengej, Fjodor A.
AU - van Royen-Kerkhof, Annet
AU - Derksen, Ronald H.W.M.
AU - Fritsch-Stork, Ruth D.E.
PY - 2017/7
Y1 - 2017/7
N2 - 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.
AB - 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.
KW - Antibodies
KW - Development
KW - Offspring
KW - Pregnancy
KW - Systemic lupus erythematosus
UR - https://www.scopus.com/pages/publications/85019967758
U2 - 10.1016/j.autrev.2017.05.005
DO - 10.1016/j.autrev.2017.05.005
M3 - Review article
AN - SCOPUS:85019967758
SN - 1568-9972
VL - 16
SP - 701
EP - 711
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
IS - 7
ER -