#5-45E. Echoes in the Womb: Maternal Rheumatic Diseases and Child Outcomes (Lancet Rheumatol, 2024)

How do maternal inflammation and autoantibody transfer shape a child's long-term development from gestation through adolescence? This comprehensive review addresses this critical clinical question by detailing how maternal autoimmune rheumatic diseases impact offspring health. While active maternal inflammation and specific autoantibodies, like anti-SSA/SSB, elevate the risk of complications such as preterm birth and congenital heart block, utilizing pregnancy-compatible immunomodulatory therapies is crucial to maintain disease stability and improve neonatal outcomes. Critically, the use of hydroxychloroquine can reduce the recurrence rate of congenital heart block by over 50%. However, when critically appraising these findings, one must recognize that studies on long-term neurodevelopmental outcomes are frequently confounded by preterm birth, maternal disease severity, and potential surveillance bias. Ultimately, this paper serves as a valuable clinical guide for physicians, equipping them with the evidence needed to bridge communication gaps with anxious parents, optimize multidisciplinary care, and reassure families that proactive, structured management generally leads to normal child development.

Citation: Andreoli, L., Andersen, J., Avcin, T., Chambers, C. D., Fazzi, E. M., Marlow, N., Wulffraat, N. M., & Tincani, A. The outcomes of children born to mothers with autoimmune rheumatic diseases. Lancet Rheumatol. 2024. DOI: 10.1016/S2665-9913(24)00096-1

URL: https://doi.org/10.1016/S2665-9913(24)00096-1

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