POS0131 LONG-TERM NEURODEVELOPMENTAL OUTCOMES OF CHILDREN, BORN TO MOTHERS WITH ANTIPHOSPHOLIPID SYNDROME (APS)
Authors: M. Zajc Avramovic, A. Ambrožič, V. Fabjan Voduses, M. Sever, T. Avčin
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Children of mothers with antiphospholipid syndrome (APS) are generally considered healthy, but recent studies have shown that they are prone to cognitive abnormalities. <h3>Objectives:</h3> The aim of this study was to assess long-term neurodevelopmental outcomes in a Slovenian cohort of children born to mothers with APS. <h3>Methods:</h3> Consecutive children of mothers with APS, referred to the University Medical Centre Ljubljana for immunologic evaluation between 2001 and 2023 were included. Demographic data, perinatal data and data related to the mother's disease were recorded from electronic medical records. Antiphospholipid antibodies (aPL) were checked at birth and at follow-up. Neurologic and cognitive development was assessed at every visit. In addition, the children were evaluated by a psychologist using general health questionnaire, the Child Behavior Check List and age appropriate Wechsler Intelligence Scale. <h3>Results:</h3> 108 children (56 boys) were included. The mean follow-up time was 4.5 years (3months – 20 years). Ninety-two percent of mothers had obstetric APS, while 8 % had thrombotic APS. Eleven percent of mothers also had systemic lupus erythematosus and 2% had Sjogren syndrome. During pregnancy 94.4 % of mothers were taking Aspirin and 87.2 % were also taking low molecular weight heparine. At birth 35.1% of newborns had positive aPL – out of these 57.9% had only aCL IgG, 36.8 % had only antiβGPI IgG and 5.2% were positive for both aCL and antiβGPI. Lupus anticoagulant was not assessed at birth. None of the children developed SLE, APS or thrombosis. Neurodevelopmental abnormality was detected in 36 % of all patients, in 50.1% of those followed for at least 3 years and in 54 % of those followed for at least 6 years. Neurodevelopmental abnormalities are shown in the Figure 1. The mean age of 37 children further assessed by psychologist was 4.8 years, 51,4 % were girls and 48,6 % boys. Seventy-two percent were born full-term, 25 % were born near-term (34-37 weeks of gestation, while one child was an extreme premature baby (born before 29 weeks of gestation), Out of these 37 children, 13.5 %, exhibited significant behavioural and emotional abnormalities (emotional problems, interpersonal relations, sleeping difficulty, distancing, pervasive developmental problem, internalisation), while 33.3 % had significantly dicrepant cognitive profile – there was a discrepance between verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) In 21.2% children VIQ&gt;PIQ, in 12.1 % children PIQ&gt;VIQ. Elements of ADHD were noted in 36.3%, one third of which was pretem. Speech/verbal abnormalities were detected in 21,2 % and 6,1 % children had problems with graphomotorics. Sixteen percent were independently reffered to psychologist and 48,6 % were followed in special neuro-development Outpatient. <h3>Conclusion:</h3> Children, born to mothers with APS are at risk of nerodevelopmental abnormalities, when they reach school-age, in more than 50 % of cases. Close follow-up and early interventions would be beneficial. <h3>REFERENCES:</h3> [1] European registry of babies born to mothers with antiphospholipid syndrome. Mekinian A et al. Annals of the rheumatic diseases, 2013. [2] Autism spectrum disorders in babies born to mothers with antiphospholipid syndrome. Abisror N et al. Seminars in arthritis and rheumatism, 2013. [3] Follow-up of babies born to mothers with antiphospholipid syndrome: preliminary data from the European neonatal registry.Motta M, Boffa M, Lachassinne E. Lupus, 2012. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>