Ethnicity and Neonatal Lupus Erythematosus Manifestations Risk in a Large Multiethnic Cohort

Talia Diaz; Daniela Dominguez; Edgar Jaeggi; Andrea M Knight; Carl A Laskin; Lawrence Ng; Franklin Silverio; Earl D Silverman; Linda T Hiraki

doi:10.3899/jrheum.201338

Ethnicity and Neonatal Lupus Erythematosus Manifestations Risk in a Large Multiethnic Cohort

J Rheumatol. 2021 Sep;48(9):1417-1421. doi: 10.3899/jrheum.201338. Epub 2021 Apr 1.

Authors

Talia Diaz¹, Daniela Dominguez¹, Edgar Jaeggi², Andrea M Knight³, Carl A Laskin⁴, Lawrence Ng¹, Franklin Silverio¹, Earl D Silverman⁵, Linda T Hiraki⁶

Affiliations

¹ T. Diaz, MD, D. Dominguez, MD, MSc, L. Ng, BSc, F. Silverio, BSc, Division of Rheumatology, The Hospital for Sick Children.
² E. Jaeggi, MD, Fetal Cardiac Program, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto.
³ A.M. Knight, MD, MSCE, Division of Rheumatology, Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto.
⁴ C.A. Laskin, MD, Mount Sinai Hospital, University of Toronto.
⁵ E.D. Silverman, MD, FRCPC, Division of Rheumatology, and Translational Medicine, Research Institute, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto.
⁶ L.T. Hiraki, MD, FRCPC, ScD, Division of Rheumatology, The Hospital for Sick Children, Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada. linda.hiraki@sickkids.ca.

PMID: 33795326
DOI: 10.3899/jrheum.201338

Abstract

Objective: To evaluate the association between ethnicity and neonatal lupus erythematosus (NLE), as well as specific NLE manifestations in a large multiethnic population.

Methods: We conducted a cohort study of the children (≤ 1 yr of age) seen in the NLE clinic at The Hospital for Sick Children (SickKids), between January 2011 and April 2019. The cohort was divided into European, non-European, and mixed European-non-European groups according to parent-reported child's ethnicity (Canada Census categories). Outcomes were NLE and specific NLE manifestations (cardiac, cutaneous, cytopenias, transaminitis, and macrocephaly). The frequency of NLE and specific manifestations were compared between ethnic groups (Fisher exact test). We tested the association between ethnicity and (1) NLE risk, and (2) specific NLE manifestations with logistic regression models, including covariates for child's sex, maternal rheumatic disease status during pregnancy, and maternal use of antimalarials during pregnancy (multiple comparisons threshold P < 0.008).

Results: We included 324 children born to 270 anti-Ro antibody-positive mothers. Median age at first visit was 1.8 (IQR 1.4-2.3) months, and median follow-up time was 12 (IQR 2-24) months. The majority was non-European (48%), with 34% European, and 18% mixed European-non-European. There was no significant association between non-European ethnicity (OR 1.18, 95% CI 0.71-1.94, P = 0.51), mixed European-non-European ethnicity (OR 1.13, 95% CI 0.59-2.16, P = 0.70), and NLE risk compared with European ethnicity. We also did not find an association between ethnicity and specific NLE manifestations in univariate or multivariable-adjusted models.

Conclusion: In a large multiethnic cohort, there was no association between a child's ethnicity and NLE risk or specific NLE manifestations.

Keywords: autoantibodies; cohort studies; congenital heart block; pediatric rheumatic diseases; pregnancy; risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Canada
Child
Cohort Studies
Ethnicity*
Female
Humans
Infant, Newborn
Lupus Erythematosus, Systemic* / congenital
Pregnancy

Supplementary concepts

Neonatal Systemic lupus erythematosus