Effects of mothers' autoimmune disease during pregnancy on
learning disabilities and hand preference in their children.
Ross G, Sammaritano L, Nass R, Lockshin M.
Department of Pediatrics, New York Presbyterian Hospital, New York, NY 10021,
USA. gailsross@aol.com
OBJECTIVES: To determine whether children (and particularly sons) of women with
systemic lupus erythematosus (SLE) during pregnancy are more likely to have
learning disabilities (LD) and be non-right-handed, and if maternal disease
variables (ie, presence of maternal antibodies, disease activity level, and use
of corticosteroids) predict the prevalence of LD in offspring. DESIGN:
Case-controlled study with subjects matched by age and sex. PARTICIPANTS: We
studied 58 children whose mothers had SLE during pregnancy and 58 children of
healthy mothers.Measures Data collected included maternal disease variables in
women with SLE during their pregnancies. All children took a standardized
intelligence test (Wechsler Intelligence Scale for Children-III) and completed a
modified version of the Edinburgh Hand Preference Questionnaire. They also took
standardized tests of reading, arithmetic, and writing achievement. Learning
disability was defined as having an academic achievement score of at least 1.5
SDs below the Full-Scale IQ. RESULTS: Sons of women with SLE were significantly
more likely to have LD than daughters of women with SLE or children of either
sex in the control group. Maternal SLE was not associated with
non-right-handedness in sons or daughters. The presence of anti-Ro/La antibodies
and disease activity (flare) in mothers during pregnancy were significantly
related to higher prevalence of LD in offspring. CONCLUSIONS: Autoimmune disease
in women during pregnancy is associated with an increased risk for LD in their
sons. Maternal antibodies, particularly anti-Ro/La, likely affect the fetal
brain of male offspring and result in later learning problems. These findings
should promote greater awareness of the risk for LD in sons of women with
autoimmune disease and the possible need for early educational intervention in
those children.
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