Long-Term Follow-up of 320 Chilren Born to Mothers with Systemic Autoimmune Diseases: A Multicentre Survey from 24 Rheumatology Centers in Italy

Maria Grazia Lazzaroni¹, Cecilia Nalli¹, Laura Andreoli¹, Chiara Carini¹, Marilia Rodrigues², Francesca Dall'Ara¹, Elena Bartoloni-Bocci³, Roberto Gerli³, Maria Gerosa⁴, Cecilia B. Chighizola⁵, Pier Luigi Meroni⁴, Luigi Sinigaglia⁶, Paola Conigliaro⁷, Roberto Perricone⁷, Ada Corrado⁸, Francesco Paolo Cantatore⁸, Salvatore D'Angelo⁹, Ignazio Olivieri⁹, Maria Favaro¹⁰, Maddalena Larosa¹⁰, Andrea Doria¹⁰, Amelia Ruffatti¹¹, Elena Generali¹², Carlo Selmi¹³, Marianna Meroni¹⁴, Maurizio Cutolo¹⁵, Melissa Padovan¹⁶, Marcello Govoni¹⁶, Giulia Pazzola¹⁷, Carlo Salvarani¹⁸, Susanna Peccatori¹⁹, Giuseppe Paolazzi¹⁹, Imma Prevete²⁰, Giovanni Minisola²⁰, Gian Domenico Sebastiani²¹, Antonio Brucato²², Véronique Ramoni²³, Roberto Caporali²⁴, Carlomaurizio Montecucco²⁴, Viola Signorini²⁵, Chiara Tani²⁶, Marta Mosca²⁵, Marica Trevisani²⁷, Nazzarena Malavolta²⁷, Marta Vadacca²⁸, Antonella Afeltra²⁹, Ester Vivaldelli³⁰, Armin Maier³⁰, Elisa Visalli³¹, Rosario Foti³¹, Carolina Benigno³², Lucia Zuliani³³, Armando Gabrielli³³, Corrado Campochiaro³⁴, Elena Baldissera³⁵, Maria Grazia Sabbadini³⁶, Nicoletta Romeo³⁷ and Angela Tincani¹, ¹University and Spedali Civili of Brescia, Brescia, Italy, ²Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, ³University and Azienda Ospedaliera of Perugia, Perugia, Italy, ⁴Istituto Ortopedico Gaetano Pini, University of Milan, Milano, Italy, ⁵Rheumatology, Istituto Auxologico Italiano, University of Milan, Cusano Milanino, Italy, ⁶Istituto Ortopedico Gaetano Pini, University of Milan, Italy, Milan, Italy, ⁷Policlinico Tor Vergata of Rome, Rome, Italy, ⁸Ospedali Riuniti of Foggia, Foggia, Italy, ⁹San Carlo Hospital of Potenza, Potenza, Italy, ¹⁰University and Azienda Ospedaliera of Padova, Padova, Italy, ¹¹Unità di Reumatologia, Dipartimento di Medicina-DIMED, Università di Padova., Padova, Italy, ¹²Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano (MI), Italy, ¹³Humanitas Research Hospital of Milan, Rozzano, Italy, ¹⁴Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS A.O.U. San Martino-IST, University of Genova, Genoa, Italy, Genova, Italy, ¹⁵Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino, Genoa, Italy, Genoa, Italy, ¹⁶UOC of Rheumatology, University Hospital S. Anna, Cona Ferrara, Italy, ¹⁷Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico of Reggio-Emilia, Reggio-Emilia, Italy, ¹⁸Rheumatology Unit, Arcispedale Santa Maria Nuova - IRCCS; Università di Modena e Reggio Emilia, Reggio-Emilia, Italy, ¹⁹Azienda Provinciale Servizi Sanitari of Trento, Trento, Italy, ²⁰Azienda Ospedaliera San Camillo of Rome, Roma, Italy, ²¹Rheumatology, San Camillo Forlanini Hospital, Roma, Italy, ²²Struttura Complessa Medicina Interna, ASST Papa Giovanni XXIII, Bergamo, Italy, ²³Ospedale Papa Giovanni XXIII of Bergamo, Policlinico San Matteo of Pavia, Bergamo, Pavia, Italy, ²⁴University and Policlinico San Matteo of Pavia, Pavia, Italy, ²⁵University of Pisa, Pisa, Italy, ²⁶Rheumatology Unit, University of Pisa, Pisa, Italy, ²⁷Policlinico S.Orsola-Malpighi, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy, ²⁸University Campus Biomedico of Rome, Roma, Italy, ²⁹University Campus Biomedico of Rome, roma, Italy, ³⁰Ospedale of Bolzano, Bolzano, Italy, ³¹Policlinico Vittorio Emanuele-Ferrarotto-Bambin Gesù of Catania, Catania, Italy, ³²University Federico II of Napoli, Napoli, Italy, ³³Ospedali Riuniti of Ancona, Ancona, Italy, ³⁴Centre for Rheumatology and Connective Tissue Diseases, UCL Division of Medicine, London, United Kingdom, ³⁵Ospedale San Raffaele of Milan, Milan, Italy, ³⁶Unit of Medicine and Clinical Immunology, Ospedale San Raffaele of Milano, Milan, Italy, ³⁷Ospedale S.Croce e Carle of Cuneo, Cuneo, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Antiphospholipid antibodies, Connective tissue diseases, Counseling, pregnancy and questionnaires

Session Information

Date: Monday, November 6, 2017

Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Rheumatic Diseases (RD) frequently affect women during reproductive age, therefore counseling on family planning is crucial for their quality of life. Children’s outcome is a major topic, but no large studies are available. This study aimed at assessing the long-term health conditions of children born to women with RD.

Methods: 24 Italian Rheumatology Centers distributed the questionnaire (65 multiple-choice and 12 open-answer questions) to consecutive patients (aged 18-55) during September 2015. Data were analyzed subdividing children upon maternal diagnosis: Chronic Arthritides (CA) and Connective Tissue Diseases (CTD).

Results: Data 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. Pre-term delivery (<37 w) was observed in 72 cases (22.5%), including 13 (4%) cases born <34 w. The occurrence of an autoimmune/inflammatory disease (AIID) and/or neurodevelopmental disorders (ND)/learning disabilities (LD) is reported in Table 1. Twelve children (3.7%) were diagnosed with an AIID, mostly coeliac disease (8/12, 67%). Eleven children (3.4%) were diagnosed as having a ND and/or LD by a Pediatric Neuropsychiatrist. To rule out the possible effects of in utero exposure to maternal autoantibodies and/or anti-rheumatic drugs in the pathogenesis of ND, data on such exposures were retrieved for 280 children (87.5%) and a comparison was performed between affected (n=11) and not-affected children (n=258) as reported in Table 2.

Conclusion: The long-term follow-up of children born to mothers with RD in this large, multicenter study of randomly interviewed women did not raise particular concerns in terms of relevant health problems. In particular, each AIID did not display a significantly increased frequency as compared to the literature (e.g. 2.5% coeliac disease as compared to 1-2% in the general pediatric population, GPP). Children with ND/LD had a tendency to cluster in the group of mothers with CTD, especially after maternal diagnosis, with a higher frequency as compared to GPP (7.9% vs 3%). No particular association with the in utero exposure to either autoantibodies or drugs was found. Therefore, our data suggest that the development of ND/LD in children of patients with RD cannot be linked exclusively to maternal disease. The results of this study can be reassuring for patients with RD about problems in the offspring possibly related to their disease.

Acknowledgements: Statistical analysis supported by an unrestricted grant by UCB Pharma. The authors wish to thank Patients Associations and Participants to the survey.

Disclosure: M. G. Lazzaroni, None; C. Nalli, None; L. Andreoli, None; C. Carini, None; M. Rodrigues, None; F. Dall'Ara, None; E. Bartoloni-Bocci, None; R. Gerli, None; M. Gerosa, None; C. B. Chighizola, None; P. L. Meroni, None; L. Sinigaglia, None; P. Conigliaro, None; R. Perricone, None; A. Corrado, None; F. P. Cantatore, None; S. D'Angelo, None; I. Olivieri, None; M. Favaro, None; M. Larosa, None; A. Doria, GSK, Pfizer, 8,Italian Association of Lupus Patients, 2,GSK, Pfizer, AstraZeneca, Celgene, Eli Lilly, Baxalta, 5; A. Ruffatti, None; E. Generali, None; C. Selmi, None; M. Meroni, None; M. Cutolo, None; M. Padovan, None; M. Govoni, None; G. Pazzola, None; C. Salvarani, None; S. Peccatori, None; G. Paolazzi, None; I. Prevete, None; G. Minisola, None; G. D. Sebastiani, None; A. Brucato, None; V. Ramoni, None; R. Caporali, None; C. Montecucco, None; V. Signorini, None; C. Tani, None; M. Mosca, None; M. Trevisani, None; N. Malavolta, None; M. Vadacca, None; A. Afeltra, None; E. Vivaldelli, None; A. Maier, None; E. Visalli, None; R. Foti, None; C. Benigno, None; L. Zuliani, None; A. Gabrielli, None; C. Campochiaro, None; E. Baldissera, None; M. G. Sabbadini, None; N. Romeo, None; A. Tincani, None.

To cite this abstract in AMA style:

Lazzaroni MG, Nalli C, Andreoli L, Carini C, Rodrigues M, Dall'Ara F, Bartoloni-Bocci E, Gerli R, Gerosa M, Chighizola CB, Meroni PL, Sinigaglia L, Conigliaro P, Perricone R, Corrado A, Cantatore FP, D'Angelo S, Olivieri I, Favaro M, Larosa M, Doria A, Ruffatti A, Generali E, Selmi C, Meroni M, Cutolo M, Padovan M, Govoni M, Pazzola G, Salvarani C, Peccatori S, Paolazzi G, Prevete I, Minisola G, Sebastiani GD, Brucato A, Ramoni V, Caporali R, Montecucco C, Signorini V, Tani C, Mosca M, Trevisani M, Malavolta N, Vadacca M, Afeltra A, Vivaldelli E, Maier A, Visalli E, Foti R, Benigno C, Zuliani L, Gabrielli A, Campochiaro C, Baldissera E, Sabbadini MG, Romeo N, Tincani A. Long-Term Follow-up of 320 Chilren Born to Mothers with Systemic Autoimmune Diseases: A Multicentre Survey from 24 Rheumatology Centers in Italy [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/long-term-follow-up-of-320-chilren-born-to-mothers-with-systemic-autoimmune-diseases-a-multicentre-survey-from-24-rheumatology-centers-in-italy/. Accessed .

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