SLE in Mothers May Lead to Increased Allergy Risk in Offspring

Children born to mothers with systemic lupus erythematosus (SLE) have a slightly increased risk of having allergic conditions, according to an article published in Arthritis Care & Research.

Julie Couture, MD, and colleagues at the Montreal Children’s Hospital of McGill University Health Center in Canada, conducted a population-based study using the Offspring of SLE Mothers Registry (OSLER) to determine if the offspring of mothers with SLE have an increased risk of developing allergic conditions compared to offspring born to mothers without SLE.

Study participants, gathered between January 1989 and December 2009 in Quebec, Canada, included 509 women with SLE who had 719 children. The women with SLE were then matched 4:1 with 5824 women without SLE prior to or at the time of delivery who had 8493 children.

The researchers used the OSLER cohort to identify children born to mothers with SLE. Researchers also used data from “Maintenance et exploitation des donnees pour l’etude de la clientele hospitalere (MED-ECHO)” and the “Regie de l’assurance maladie du Quebec (RAMQ)” billing database.

The study examined allergic conditions in offspring based on ≥1 hospitalization or ≥1 physician visits with a diagnostic code of upper airway anaphylactic reaction, anaphylaxis, urticaria, and allergy without other indication, and on ≥1 hospitalization or ≥2 physician visits for allergic rhinitis, asthma, and eczema.

The researchers performed univariate and multivariate analyses to estimate the odds ratio (OR) for the outcome of interest. With a mean maternal SLE disease duration of 3.7 years and a mean follow-up of 9.1 years, the results found that the offspring of mothers with SLE had more allergic conditions compared with the control cohort, 43.9% (95% CI 40.4, 47.6) vs 38.1% (95% CI 37.0, 39.1). The most frequently observed allergic conditions in SLE offspring were eczema (16.4%) and asthma (16.1%), while anaphylaxis was the least frequent (0.3%).

In the multivariate analysis (n=9212), offspring of mothers with SLE also had an increased risk of allergic conditions compared to offspring in the control group, OR 1.35, 95% CI 1.13, 1.61.

“Genetics, shared environmental exposures, as well as in utero exposure to maternal autoantibodies and cytokines might explain the increased risk of allergic conditions in these children,” the researchers explain.

Reference

Couture J, Ben-Shoshan M, Pineau CA, et al. Risk of allergic conditions in children born to women with systemic lupus erythematosus [published online April 6, 2017]. Arthritis Care Res (Hoboken). doi:10.1002/acr.23251.