Effects of mothers' autoimmune disease during pregnancy on learning disabilities and hand preference in their children
Effects of mothers' autoimmune disease during pregnancy on learning disabilities and hand preference in their children
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DOI：
10.1001/archpedi.157.4.397
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发表时间：
2003-04-01
影响因子：
--
通讯作者：
Lockshin, M
中科院分区：
文献类型：
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作者：
Ross, G;Sammaritano, L;Lockshin, M
目的：为了确定孩子们是否系统性红斑狼疮（SLE）妇女在怀孕期间（特别是儿子）更有可能有学习障碍（LD）和非右利手，如果母亲的疾病变量（即母体抗体的存在、疾病活动水平和皮质类固醇的使用）预测后代LD的患病率。设计：病例对照研究，受试者年龄和性别匹配。参与者：我们研究了58名儿童的母亲有SLE在怀孕期间和58名儿童的健康mothers.Measures：收集的数据包括母亲的疾病变量SLE妇女在怀孕期间。所有儿童进行了标准化的智力测试（韦氏儿童智力量表-III），并完成了修改版的爱丁堡手偏好问卷。他们还参加了阅读、算术和写作成绩的标准化测试。学习障碍被定义为具有至少1.5 SD以下的全量表iQ.Results的学业成绩得分：SLE的妇女的儿子比SLE的妇女或儿童的任何性别的对照组中的女儿更有可能有LD。母亲SLE与儿子或女儿的非右利手无关。抗Ro/La抗体和疾病活动（耀斑）在母亲怀孕期间的存在显着相关的LD在后代的患病率较高。结论：自身免疫性疾病在妇女怀孕期间与LD在他们的儿子的风险增加。母体抗体，特别是抗Ro/La抗体，可能会影响男性后代的胎儿大脑，并导致以后的学习问题。这些发现应该促进对自身免疫性疾病妇女的儿子LD风险的认识，并可能需要对这些儿童进行早期教育干预。
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.