ps4 79 long term follow up of 320 chilren born to mothers with systemic autoimmune diseases a multicentre survey from 24 rheumatology centres in italy

Background Rheumatic Diseases (RD) frequently affect women during reproductive age, therefore counselling on family planning is crucial for their quality of life. Children's outcome is a major topic, but no large studies are available. This study aimed at assessing the long-term health conditions of children born to women with RD. Methods 24 Italian Rheumatology Centres distributed the questionnaire (65 multiple-choice and 12 open-answer questions) to consecutive patients (aged 18–55) during September 2015. Data were analysed dividing children upon maternal diagnosis: Chronic Arthritides (CA) and Connective Tissue Diseases (CTD). Results Data were collected for 320 children born to 184 mothers (63 CA and 121 CTD). At the time of interview, children had a mean age of 17.1±9.6 years. Pre-term delivery ( The occurrence of an autoimmune/inflammatory disease (AIID) and/or neurodevelopmental disorders (ND)/learning disabilities (LD) is reported in table 1. Twelve children (3.7%) were diagnosed with an AIID, mostly coeliac disease (8/12, 67%). Eleven children (3.4%) were diagnosed as having a ND and/or LD by a Paediatric Neuropsychiatrist. Data of in utero exposure to maternal autoantibodies and/or anti-rheumatic drugs were retrieved for 280 children (87.5%) and a comparison was performed between affected (n=11) and not-affected children (n=258). No association was found with ND/LD and in utero exposure to autoantibodies (ANA, anti-Ro, anti-dsDNA, aPL) or drugs (HCQ,AZA or steroids), neither with sex, preterm birth, birth weight or maternal diagnosis. Conclusions The long-term follow-up of children born to mothers with RD did not raise particular concerns in terms of relevant health problems. In particular, each AIID did not display a significantly increased frequency as compared to the literature. Children with ND/LD had a tendency to cluster in the group of mothers with CTD, especially after maternal diagnosis, with a higher frequency as compared to GPP (7.9% vs 3%). Our data suggest that the development of ND/LD in children of patients with RD cannot be linked exclusively to maternal disease. The results of this study can be reassuring for patients with RD about problems in the offspring possibly related to their disease

Long-term Outcome of Children Born to Women with Autoimmune Rheumatic Diseases: A Multicentre, Nationwide Study on 299 Randomly Selected Individuals

63siThe concern about the offspring’s health is one of the reasons for a reduced family size of women with rheumatic diseases (RD). Increased risk of autoimmune diseases (AD) and neurodevelopmental disorders (ND) has been reported in children born to patients with RD. Within a nationwide survey about reproductive issues of women with RD, we aimed at exploring the long-term outcome of their children. By surveying 398 patients who received their diagnosis of RD during childbearing age (before the age of 45), information about the offspring were obtained from 230 women who declared to have had children. A total of 148 (64.3%) patients were affected by connective tissue diseases (CTD) and 82 (35.7%) by chronic arthritis. Data on 299 children (156 males, 52.1%; mean age at the time of interview 17.1 ± 9.7 years) were collected. Twelve children (4.0%), who were born to patients with CTD in 75% of the cases, were affected by AD (8 cases of celiac disease). Eleven children had a certified diagnosis of ND (3.6%; 6 cases of learning disabilities); 9 of them were born to mothers with CTD (5 after maternal diagnosis). No association was found between ND and prenatal exposure to either maternal autoantibodies or anti-rheumatic drugs. Absolute numbers of offspring affected by AD and ND were low in a multicentre cohort of Italian women with RD. This information can be helpful for the counselling about reproductive issues, as the health outcomes of the offspring might not be an issue which discourage women with RD from having children.nonenoneAndreoli L.; Nalli C.; Lazzaroni M.G.; Carini C.; Dall'Ara F.; Reggia R.; Rodrigues M.; Benigno C.; Baldissera E.; Bartoloni E.; Basta F.; Bellisai F.; Bortoluzzi A.; Campochiaro C.; Cantatore F.P.; Caporali R.; Ceribelli A.; Chighizola C.B.; Conigliaro P.; Corrado A.; Cutolo M.; D'Angelo S.; De Stefani E.; Doria A.; Favaro M.; Fischetti C.; Foti R.; Gabrielli A.; Generali E.; Gerli R.; Gerosa M.; Larosa M.; Maier A.; Malavolta N.; Meroni M.; Meroni P.L.; Montecucco C.; Mosca M.; Padovan M.; Paolazzi G.; Pazzola G.; Peccatori S.; Perricone R.; Pettiti G.; Picerno V.; Prevete I.; Ramoni V.; Romeo N.; Ruffatti A.; Salvarani C.; Sebastiani G.D.; Selmi C.; Serale F.; Sinigaglia L.; Tani C.; Trevisani M.; Vadacca M.; Valentini E.; Valesini G.; Visalli E.; Vivaldelli E.; Zuliani L.; Tincani A.Andreoli, L.; Nalli, C.; Lazzaroni, M. G.; Carini, C.; Dall'Ara, F.; Reggia, R.; Rodrigues, M.; Benigno, C.; Baldissera, E.; Bartoloni, E.; Basta, F.; Bellisai, F.; Bortoluzzi, A.; Campochiaro, C.; Cantatore, F. P.; Caporali, R.; Ceribelli, A.; Chighizola, C. B.; Conigliaro, P.; Corrado, A.; Cutolo, M.; D'Angelo, S.; De Stefani, E.; Doria, A.; Favaro, M.; Fischetti, C.; Foti, R.; Gabrielli, A.; Generali, E.; Gerli, R.; Gerosa, M.; Larosa, M.; Maier, A.; Malavolta, N.; Meroni, M.; Meroni, P. L.; Montecucco, C.; Mosca, M.; Padovan, M.; Paolazzi, G.; Pazzola, G.; Peccatori, S.; Perricone, R.; Pettiti, G.; Picerno, V.; Prevete, I.; Ramoni, V.; Romeo, N.; Ruffatti, A.; Salvarani, C.; Sebastiani, G. D.; Selmi, C.; Serale, F.; Sinigaglia, L.; Tani, C.; Trevisani, M.; Vadacca, M.; Valentini, E.; Valesini, G.; Visalli, E.; Vivaldelli, E.; Zuliani, L.; Tincani, A

\u201cDisease knowledge index\u201d and perspectives on reproductive issues: A nationwide study on 398 women with autoimmune rheumatic diseases

Objective: The reproductive choices of women affected by rheumatic diseases (RD) can be influenced by several factors, including the quality of physician-patient communication. We conducted a survey on reproductive issues aiming at exploring the unmet needs of women with RD during childbearing age.Methods: We administered 65 multiple-choice and 12 open-answer questions about pregnancy counselling, contraception, use of drugs during pregnancy and other women reproductive issues to 477 consecutive women with RD aged 18-55 years followed-up in 24 rheumatology centres in Italy. Analysis was restricted to 398 patients who received their diagnosis of RD before the age of 45. According to the RD diagnosis, patients were subdivided into 2 groups: connective tissue diseases (n = 249) and chronic arthritis (n = 149).Results: At the time of interview, women in both groups had a mean age of 40 years. Nearly one third of patients in each group declared not to have received any counselling about either pregnancy desire nor contraception. A smaller family size than desired was reported by nearly 37% of patients, because of concerns related to maternal disease in one fourth of the cases. A "Disease Knowledge Index" (DKI) was created to investigate the degree of patients' information about the implications of their RD on reproductive issues. Having received counselling was associated with higher DKI values and with a positive impact on family planning.Conclusion: Italian women of childbearing age affected by RD reported several unmet needs in their knowledge about reproductive issues. Strategies are needed to implement and facilitate physician-patient communication. (C) 2018 Published by Elsevier Masson SAS on behalf of Societe francaise de rhumatologie