Impact of in utero environment on the offspring of lupus patients
Identifieur interne : 000334 ( France/Analysis ); précédent : 000333; suivant : 000335Impact of in utero environment on the offspring of lupus patients
Auteurs : A. Tincani [Italie] ; E. Danieli ; M. Nuzzo ; M. Scarsi ; M. Motta [Italie] ; R. Cimaz [France] ; A. Lojacono ; R. Nacinovich ; F. Taddei [Italie] ; A. Doria [Italie] ; A. Brucato [Italie] ; P. Meroni [Italie] ; for the Pregnancy Study Group of Italian Society of RheumatologySource :
- Lupus [ 0961-2033 ] ; 2006-11.
English descriptors
- Teeft :
- Active lupus, Antiphospholipid, Antiphospholipid antibodies, Antiphospholipid syndrome, Arthritis rheum, Autoimmune, Autoimmune disease, Birth weight, Breast milk, Brotic changes, Buyon, Congenital, Congenital heart block, Connective tissue diseases, Corticosteroid, Critical period, Direct effect, Early diagnosis, Erythematosus, Fetal, Fetal development, Fetal growth restriction, Fetal loss, Fetal losses, Fetal lung maturity, Fetal origin, Fetus, General population, Heart block, High dose, High frequency, High risk, Immunosuppressive, Immunosuppressive drugs, Intrauterine growth restriction, Long half life, Long term, Long term outcome, Lupus, Lupus activity, Lupus impact, Lupus patients, Lupus pregnancy, Maternal, Maternal antibodies, Maternal autoantibodies, Maternal blood, Maternal disease, Maternal treatment, National registry, Neonatal, Neonatal lupus, Neonatal lupus syndrome, Neonatal outcome, Neuropsychological, Neuropsychological development, Obstet gynecol, Other factors, Other hand, Pathogenic role, Petri, Positive mothers, Pregnancy, Pregnancy loss, Pregnancy outcome, Pregnant patients, Preterm, Preterm birth, Preterm delivery, Renal, Renal disease, Rheum, Risk factors, Syndrome, Systemic, Systemic lupus erythematosus, Tincani, Uorinated corticosteroids, Utero, Utero environment, Utero exposure.
Abstract
The number of patients affected by systemic lupus erythematosus (SLE) that decide to have children has greatly increased probably because of recent improvements in the diagnosis and management of the disease. This has stimulated our interest in defining the outcome of children, focusing both on neonatal problems and long term development. SLE patients still carry a risk of pregnancy loss. However, due to careful monitoring and treatment by a multidisciplinary team, the number of losses has dramatically decreased, but an increased number of preterm deliveries is still a problem. Neonatal lupus is linked to the presence of anti-Ro/SS-A and anti-La/SS-B antibodies in the mother, although other factors probably of fetal origin are important. Neonatal lupus is a complex condition whose most serious manifestation is the congenital heart block (CHB). Usually, children with complete CHB need permanent pacing, but apparently do not have neuropsychological problems. Studies focusing on the neuropsychological development of SLE offspring show an increased number of learning disabilities in children with normal intelligence levels. Fetal consequence of maternal treatment need to be considered choosing non teratogenic drugs, but the withdrawal of medications just because the patient is pregnant should be avoided to avoid SLE flares.
Url:
DOI: 10.1177/0961203306071005
Affiliations:
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Tincani</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Spedali Civili and University of Brescia, Brescia, Italy; Reumatologia e Immunologia Clinica, Ospedale Civile di Brescia, 25125 Brescia</wicri:regionArea><wicri:noRegion>25125 Brescia</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Italie</country></affiliation></author><author wicri:is="90%"><name sortKey="Danieli, E" sort="Danieli, E" uniqKey="Danieli E" first="E" last="Danieli">E. Danieli</name></author><author wicri:is="90%"><name sortKey="Nuzzo, M" sort="Nuzzo, M" uniqKey="Nuzzo M" first="M" last="Nuzzo">M. Nuzzo</name></author><author wicri:is="90%"><name sortKey="Scarsi, M" sort="Scarsi, M" uniqKey="Scarsi M" first="M" last="Scarsi">M. Scarsi</name></author><author wicri:is="90%"><name sortKey="Motta, M" sort="Motta, M" uniqKey="Motta M" first="M" last="Motta">M. Motta</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Spedali Civili and University of Brescia, Brescia</wicri:regionArea><wicri:noRegion>Brescia</wicri:noRegion></affiliation></author><author wicri:is="90%"><name sortKey="Cimaz, R" sort="Cimaz, R" uniqKey="Cimaz R" first="R" last="Cimaz">R. Cimaz</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>University of Lyon</wicri:regionArea></affiliation></author><author wicri:is="90%"><name sortKey="Lojacono, A" sort="Lojacono, A" uniqKey="Lojacono A" first="A" last="Lojacono">A. Lojacono</name></author><author wicri:is="90%"><name sortKey="Nacinovich, R" sort="Nacinovich, R" uniqKey="Nacinovich R" first="R" last="Nacinovich">R. Nacinovich</name></author><author wicri:is="90%"><name sortKey="Taddei, F" sort="Taddei, F" uniqKey="Taddei F" first="F" last="Taddei">F. Taddei</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Spedali Civili and University of Brescia, Brescia</wicri:regionArea><wicri:noRegion>Brescia</wicri:noRegion></affiliation></author><author wicri:is="90%"><name sortKey="Doria, A" sort="Doria, A" uniqKey="Doria A" first="A" last="Doria">A. Doria</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>University Hospital-Padua, Padova</wicri:regionArea><wicri:noRegion>Padova</wicri:noRegion></affiliation></author><author wicri:is="90%"><name sortKey="Brucato, A" sort="Brucato, A" uniqKey="Brucato A" first="A" last="Brucato">A. Brucato</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Ospedale Niguarda, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author wicri:is="90%"><name sortKey="Meroni, P" sort="Meroni, P" uniqKey="Meroni P" first="P" last="Meroni">P. Meroni</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>IRCCS Ist. Auxologico University of Milan, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author wicri:is="90%"><name sortKey="For The Pregnancy Study Group Of Italian Society Of Rheumatology" sort="For The Pregnancy Study Group Of Italian Society Of Rheumatology" uniqKey="For The Pregnancy Study Group Of Italian Society Of Rheumatology" first="" last="For The Pregnancy Study Group Of Italian Society Of Rheumatology">for the Pregnancy Study Group of Italian Society of Rheumatology</name></author></analytic><monogr></monogr><series><title level="j">Lupus</title><idno type="ISSN">0961-2033</idno><idno type="eISSN">1477-0962</idno><imprint><publisher>Sage Publications</publisher><pubPlace>Sage CA: Thousand Oaks, CA</pubPlace><date type="published" when="2006-11">2006-11</date><biblScope unit="volume">15</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="801">801</biblScope><biblScope unit="page" to="807">807</biblScope></imprint><idno type="ISSN">0961-2033</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0961-2033</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Active lupus</term><term>Antiphospholipid</term><term>Antiphospholipid antibodies</term><term>Antiphospholipid syndrome</term><term>Arthritis rheum</term><term>Autoimmune</term><term>Autoimmune disease</term><term>Birth weight</term><term>Breast milk</term><term>Brotic changes</term><term>Buyon</term><term>Congenital</term><term>Congenital heart block</term><term>Connective tissue diseases</term><term>Corticosteroid</term><term>Critical period</term><term>Direct effect</term><term>Early diagnosis</term><term>Erythematosus</term><term>Fetal</term><term>Fetal development</term><term>Fetal growth restriction</term><term>Fetal loss</term><term>Fetal losses</term><term>Fetal lung maturity</term><term>Fetal origin</term><term>Fetus</term><term>General population</term><term>Heart block</term><term>High dose</term><term>High frequency</term><term>High risk</term><term>Immunosuppressive</term><term>Immunosuppressive drugs</term><term>Intrauterine growth restriction</term><term>Long half life</term><term>Long term</term><term>Long term outcome</term><term>Lupus</term><term>Lupus activity</term><term>Lupus impact</term><term>Lupus patients</term><term>Lupus pregnancy</term><term>Maternal</term><term>Maternal antibodies</term><term>Maternal autoantibodies</term><term>Maternal blood</term><term>Maternal disease</term><term>Maternal treatment</term><term>National registry</term><term>Neonatal</term><term>Neonatal lupus</term><term>Neonatal lupus syndrome</term><term>Neonatal outcome</term><term>Neuropsychological</term><term>Neuropsychological development</term><term>Obstet gynecol</term><term>Other factors</term><term>Other hand</term><term>Pathogenic role</term><term>Petri</term><term>Positive mothers</term><term>Pregnancy</term><term>Pregnancy loss</term><term>Pregnancy outcome</term><term>Pregnant patients</term><term>Preterm</term><term>Preterm birth</term><term>Preterm delivery</term><term>Renal</term><term>Renal disease</term><term>Rheum</term><term>Risk factors</term><term>Syndrome</term><term>Systemic</term><term>Systemic lupus erythematosus</term><term>Tincani</term><term>Uorinated corticosteroids</term><term>Utero</term><term>Utero environment</term><term>Utero exposure</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The number of patients affected by systemic lupus erythematosus (SLE) that decide to have children has greatly increased probably because of recent improvements in the diagnosis and management of the disease. This has stimulated our interest in defining the outcome of children, focusing both on neonatal problems and long term development. SLE patients still carry a risk of pregnancy loss. However, due to careful monitoring and treatment by a multidisciplinary team, the number of losses has dramatically decreased, but an increased number of preterm deliveries is still a problem. Neonatal lupus is linked to the presence of anti-Ro/SS-A and anti-La/SS-B antibodies in the mother, although other factors probably of fetal origin are important. Neonatal lupus is a complex condition whose most serious manifestation is the congenital heart block (CHB). Usually, children with complete CHB need permanent pacing, but apparently do not have neuropsychological problems. Studies focusing on the neuropsychological development of SLE offspring show an increased number of learning disabilities in children with normal intelligence levels. Fetal consequence of maternal treatment need to be considered choosing non teratogenic drugs, but the withdrawal of medications just because the patient is pregnant should be avoided to avoid SLE flares.</div></front></TEI><affiliations><list><country><li>France</li><li>Italie</li></country><region><li>Lombardie</li></region><settlement><li>Milan</li></settlement></list><tree><noCountry><name sortKey="Danieli, E" sort="Danieli, E" uniqKey="Danieli E" first="E" last="Danieli">E. Danieli</name><name sortKey="For The Pregnancy Study Group Of Italian Society Of Rheumatology" sort="For The Pregnancy Study Group Of Italian Society Of Rheumatology" uniqKey="For The Pregnancy Study Group Of Italian Society Of Rheumatology" first="" last="For The Pregnancy Study Group Of Italian Society Of Rheumatology">for the Pregnancy Study Group of Italian Society of Rheumatology</name><name sortKey="Lojacono, A" sort="Lojacono, A" uniqKey="Lojacono A" first="A" last="Lojacono">A. Lojacono</name><name sortKey="Nacinovich, R" sort="Nacinovich, R" uniqKey="Nacinovich R" first="R" last="Nacinovich">R. Nacinovich</name><name sortKey="Nuzzo, M" sort="Nuzzo, M" uniqKey="Nuzzo M" first="M" last="Nuzzo">M. Nuzzo</name><name sortKey="Scarsi, M" sort="Scarsi, M" uniqKey="Scarsi M" first="M" last="Scarsi">M. Scarsi</name></noCountry><country name="Italie"><noRegion><name sortKey="Tincani, A" sort="Tincani, A" uniqKey="Tincani A" first="A" last="Tincani">A. Tincani</name></noRegion><name sortKey="Brucato, A" sort="Brucato, A" uniqKey="Brucato A" first="A" last="Brucato">A. Brucato</name><name sortKey="Doria, A" sort="Doria, A" uniqKey="Doria A" first="A" last="Doria">A. Doria</name><name sortKey="Meroni, P" sort="Meroni, P" uniqKey="Meroni P" first="P" last="Meroni">P. Meroni</name><name sortKey="Motta, M" sort="Motta, M" uniqKey="Motta M" first="M" last="Motta">M. Motta</name><name sortKey="Taddei, F" sort="Taddei, F" uniqKey="Taddei F" first="F" last="Taddei">F. Taddei</name><name sortKey="Tincani, A" sort="Tincani, A" uniqKey="Tincani A" first="A" last="Tincani">A. Tincani</name></country><country name="France"><noRegion><name sortKey="Cimaz, R" sort="Cimaz, R" uniqKey="Cimaz R" first="R" last="Cimaz">R. Cimaz</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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