Children born to mothers with SLE might have increased risk of autism spectrum disorders

SAN DIEGO — Although rare, children born to mothers with systemic lupus erythematosus had a twofold increased risk for autism spectrum disorders when compared with children born to women without the disease, according to research presented at the American College of Rheumatology annual meeting.

Researchers used the Offspring of Lupus Erythematosus mothers Registry (OSLER), a large Canadian population-based cohort, which includes all women with at least one hospitalization for delivery after diagnosis of systemic lupus erythematosus (SLE) to identify 509 women with SLE who had 719 children. They also used OSLER to include 5,824 randomly selected women in a matched control cohort who did not have SLE diagnosis prior to or at the time of delivery (n= 8,493 children). Autism spectrum disorder (ASD) was ascertained through database follow-up.

Evelyne Vinet

Multivariate analyses adjusted for maternal demographics, gender and birth order of child, along with obstetrical complications.

The mean age of the women was 30.3 years, with an average follow-up of 9.1 years. There were more records of ASD diagnoses in children born to women with SLE (1.4%; 95% CI, 0.8%-2.5%) compared with children in the control cohort (0.6%; 95% CI, 0.5-0.8). The children of SLE mothers had a slightly younger mean age at ASD diagnosis (3.8 years; 95% CI, 1.8-5.8 years) compared with controls (5.7 years; 95% CI, 4.9-6.5 years). Risk of ASD was substantially increased in the children born to women with SLE compared to controls in multivariate analyses (HR=2.31; 95% CI, 1.03-5.16).

A subsample study of 1,925 children with maternal public drug coverage throughout the pregnancy also was conducted. In 18 ASD cases identified, none of the children were exposed to antimalarials, antidepressants or immunosuppressants. One child born to a mother with SLE and another born to a mother in the control cohort were exposed to corticosteroids and anticonvulsants, respectively.

“Compared to children in the general population, children born to mothers with lupus have a two-fold increase in the risk of autism spectrum disorder,” researcher Evelyne Vinet, MD, FRCPC, assistant professor, Department of Rheumatology, McGill University Health Centre, said . “We want to stress that the absolute risk is small.

“The take-home message for women with lupus is to not be alarmed by our study findings because … this is still a very small risk."

She added that women with lupus who are contemplating a pregnancy should discuss with their physician the best timing, possibly when they are in remission.

Disclosures: The researchers report no relevant financial disclosures.

For more information:

Vinet E. #2831. Increased Risk of Autism Spectrum Disorders in Children Born to Women with SLE: Preliminary Data from The OSLER Cohort. Presented at: American College of Rheumatology Annual Meeting; Oct. 26-30, San Diego.