| In utero azathioprine exposure and increased utilization of special educational services in children born to mothers with systemic lupus erythematosus. | |
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MedLine Citation:
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PMID: 23139238 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Azathioprine (AZA) is recognized among immunosuppressive medications as relatively safe during pregnancy for women with systemic lupus erythematosus (SLE) requiring aggressive treatment. This pilot study aimed to determine whether SLE therapy during pregnancy was associated with developmental delays in offspring. METHODS: This cohort study included SLE patients with at least one live birth post-diagnosis. Medical histories were obtained via interviews and chart review. Multiple logistic regression was used to examine associations between SLE therapy during pregnancy and maternal report of special educational (SE) requirements (as proxy for developmental delays) among offspring. Propensity scoring (incorporating corticosteroid use, lupus flare, and lupus nephritis) was used to account for disease severity. RESULTS: Of 60 eligible offspring from 38 mothers, 15 required SE services, the most common indication for which was speech delay. 7 of the 13 (54%) children with in utero AZA exposure utilized SE services versus 8 of 47 (17%) non-exposed (p<0.05). After adjustment for pregnancy duration, small for gestational age, propensity score, maternal education and antiphospholipid antibody syndrome, AZA was significantly associated with SE utilization occurring from age 2 onward (OR 6.6, 95% CI 1.0, 43.3), and bordered significance for utilization at any age or age <2 years. CONCLUSIONS: AZA exposure during SLE pregnancy was independently associated with increased SE utilization in offspring, after controlling for confounders. Further research is indicated to fully characterize developmental outcomes among offspring with in utero AZA exposure. Vigilance and early interventions for suspected developmental delays among exposed offspring may be warranted. © 2012 by the American College of Rheumatology. |
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Authors:
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Wendy Marder; Martha A Ganser; Vivian Romero; Margaret A Hyzy; Caroline Gordon; Wj McCune; Emily C Somers |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-8 |
Journal Detail:
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Title: Arthritis care & research Volume: - ISSN: 2151-4658 ISO Abbreviation: Arthritis Care Res (Hoboken) Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101518086 Medline TA: Arthritis Care Res (Hoboken) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 by the American College of Rheumatology. |
Affiliation:
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Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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