Infants of mothers with systemic connective tissue disease – serological and clinical status in the first year of life; a pilot study

Introduction
Neonatal lupus erythematosus (NLE) is an uncommon autoimmune disease caused by transplacental passage of maternal antibodies. The aim of the study was to investigate whether antinuclear antibodies (ANA) detected in newborns of mothers with systemic connective tissue disease (SCTD) are present after 6 months of age, and whether they are accompanied by clinical symptoms, the so-called NLE.

Material and methods
A prospective pilot study was conducted in a group of 20 full-term newborns (11 males and 9 females) consequently born to mothers with SCTD and 6 newborns (3 males and 3 females) of mothers without autoimmune disease. The infants were examined for symptoms of NLE. The ANA profile was evaluated in newborns and repeated at the age of 7 months by using the indirect immunofluorescence technique.

Results
ANA was detected in 16/20 newborns from the study group in titre 1 : 40 to 1 : 2560 and in 4/6 newborns from the control group in titre 1 : 40 to 1 : 320, as well as in 9 of 19 7-months-old babies of SCTD mothers. There were no skin lesions, and elevated liver enzymes were found in 8 newborns and haematological changes in 7 newborns. No pathological changes were found in the ECG examination in the neonatal period in any of the children.

Conclusions
Maternal ANAs are detected in newborns and in 7-month-old babies. Despite 80% of ANA detection in the neonatal period of infants of SCTD mothers and 47% detection in 7-month-old babies, there were no evident symptoms of NLE besides some elevated levels of liver enzymes and haematological changes.