OP0098 TRAJECTORIES OF GROWTH IN OFFSPRING FROM MOTHERS WITH PREVALENT OR PRE-SYSTEMIC LUPUS ERYTHEMATOSUS: A NATIONWIDE POPULATION-BASED STUDY IN KOREA
Authors: I. A. Choi, J. H. Kim, S. A. Yoon, S. H. Chang, H. J. Kim, H. S. Ahn
Journal: Annals of the Rheumatic Diseases (2020)

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects women of childbearing age and is known to have poor maternal and fetal outcomes associated with pregnancy. Objectives: We planned on the long-term follow-up studies to find out whether SLE offspring with low birth weight would properly catch up in future childhood life. Methods: Korean National Health Insurance (NHI) service is a mandatory, single public health insurance system that covers more than 50,000,000 Korean population. It consists of inpatient and outpatient diagnosis and treatment data for the purpose of reimbursement. Rare and Intractable Diseases (RID) registration system is a copayment reduction scheme which provides financial support to patients with certain rare disease, include SLE. National Health Screening Program for Infants and Children (NSHPIC) is a population screening system for children aged 4 to 71 months, requiring 7 visits to participating clinic at pre-specified times. Among the children who were born between 2008 and 2013, we identified those who completed the first (between 4-6th month), second (between 9-12th month) and either sixth or seventh examination (between 54-65th month and 66-71th month, respectively) of NSHPIC. By linking maternal and offspring healthcare data through their unique personal identification numbers, we constructed a mother-child database to track the growth of the child. Among their mothers, we could identify SLE patients who had given live singleton births using RID database (V136) and the international classification of disease code (M32.x) for SLE. Therefore, we were able to follow birth weight and subsequent growth of offspring according to their mother’s disease status. Results: We could identify 1,007 offspring from SLE mothers and 793,537 control from non-SLE mothers. Offspring from SLE mothers showed the higher risk of low birth weight defined as less than 2500g [hazard ratio (HR) 4.79, 95% confidence interval (CI) 4.08–5.63]. In terms of subgroups analysis according to the time of diagnosis, the risk of low birth weight was the highest in offspring from those who diagnosed SLE during pregnancy (HR 8.22, 95% CI 3.18–21.26). In addition, the risk of low birthweight increased not only in offspring from already diagnosed SLE before pregnancy (HR 5.63, 95% CI 4.41–7.19), but also in offspring from those who diagnosed with SLE after delivery (pre-SLE) compared to general population (HR 2.03, 95% CI 1.33–3.09). Subsequent growth failure defined as less than 3 percentile was more prevalent in SLE offspring compared to general population at 4-6 month (HR 3.28, 95% CI 2.22–4.77). However, at 6-9 months and 54-71 months, the gap was reduced, showing no statistical difference with the general population (HR 1.22, 95% CI 0.73–2.03 and HR 1.26, 95% CI 0.88–1.80, respectively). Among SLE offspring with low birth weight (&lt; 2500g), 89.34% showed the body weight of 3 percentile or more and 75.84% showed the body weight 10 percentile or more at 4-6 month. The proportion of children who catch up afterwards has not increased since then, as the proportion of children who were more than 10 percentile was 81.46% at 6-9 months and 80.34% at 54-71 months. Conclusion: The offspring of SLE patients were more likely to have low birthweight compared to general population, but majority of them showed the catch up growth at 4-6 month of age. The risk of low birthweight was especially high in the offspring from mothers who diagnosed SLE during pregnancy. Disclosure of Interests: None declared