Children Born to Women With SLE May Have Increased Congenital Heart Disease Risk

Children born to women with systemic lupus erythematosus (SLE) may have an increased risk of congenital heart disease, as well as an increased risk of having a congenital heart disease repair procedure, according to a study published Oct. 29 in Circulation.

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An incredibly harmful, and to date incurable, autoimmune disease that attacks the body’s cells and tissue, SLE predominantly occurs in women of childbearing age, affecting approximately 1.5 in every 1,000 females aged 18-44. With very few uncontrolled observational studies assessing congenital heart disease in the offspring of mothers with SLE, Évelyne Vinet, MD, Division of Clinical Epidemiology, McGill University Health Centre, Montreal, and her colleagues aimed to determine whether children born to women with SLE were at an increased risk of congenital heart disease compared to children born to women without SLE.

Utilizing data from the Quebec MEDECHO physician billing databases, Vinet and her co-authors identified all women with SLE who had one or more hospitalizations for a delivery resulting in a stillbirth or live birth between January 1989 and December 2009, creating their own “Offspring of SLE Mothers Registry,” a population-based cohort of 719 children born to mothers with SLE, matched to 8,493 control children.

Compared to the controls, children born to women with SLE experienced more congenital heart disease [5.2 percent (95 percent CI 3.7-7.1) versus 1.9 percent (95 percent CI 1.6-2.2). In multivariable analyses, children born to women with SLE also had a substantially increased risk of congenital heart disease (OR 2.62, 95 percent CI 1.77-3.88) and having a congenital heart disease repair procedure (OR 5.82, 95 percent CI 1.77-19.09) compared to controls.

Ultimately, Vinet and her colleagues conclude that their findings prompt further research to elucidate the potential role of disease-related factors such as in utero drug exposure, maternal autoantibodies and cytokines, which could explain the increased likelihood of congenital heart disease in children born to mothers with SLE.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology

Keywords: Child, Autoantibodies, Stillbirth, Lupus Erythematosus, Systemic, Cytokines, Live Birth, Mothers, Hospitalization


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