Neurodevelopment in children with and without congenital heart block born to anti-Ro/SSA-positive mothers

Acta Paediatr. 2013 Jan;102(1):40-6. doi: 10.1111/apa.12049. Epub 2012 Nov 1.

Abstract

Objective: To define factors influencing neurodevelopment in children with and without complete congenital heart block (CHB) born to mothers with Ro/SSA autoantibodies.

Patients and methods: Medical records of a population-based cohort of siblings with (n = 60) and without (n = 54) CHB born 1974-2009 to anti-Ro/SSA-positive mothers were retrieved from children primary healthcare centres and school health services and used to extract data on neurodevelopment.

Results: Impaired neurodevelopment was reported in 16% of the children (18/114) during the follow-up time of 13.0 (8.2-17.5) years, median (quartiles). Reported problems included speech (9%), motor (8%) and learning (8%) impairment, attention deficit (5%) and behavioural impairment (4%). Impairment in motor skill development was more common in boys (p < 0.001) if the child was born preterm (p < 0.001). Learning impairment was significantly influenced by maternal SLE (p < 0.005), while attention deficits was influenced by both maternal SLE (p < 0.05) and CHB in the child (p < 0.05).

Conclusions: Our data indicate that in addition to well-established factors such as male sex and being born preterm, both maternal SLE and CHB may influence neurodevelopment. Follow-up of neurodevelopment should therefore be considered for children with CHB, especially if the mother is diagnosed with SLE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies
  • Child Development*
  • Female
  • Heart Block / congenital*
  • Heart Block / physiopathology
  • Humans
  • Infant, Newborn
  • Lupus Erythematosus, Systemic / immunology
  • Male
  • Nervous System / growth & development*
  • Pregnancy
  • Pregnancy Complications / immunology
  • Retrospective Studies
  • Ribonucleoproteins / immunology

Substances

  • Autoantibodies
  • Ribonucleoproteins
  • SS-A antigen

Supplementary concepts

  • Congenital heart block