Cerebral ultrasound abnormalities in infants born to mothers with autoimmune disease.

OBJECTIVES

Cerebral abnormalities detected by cranial ultrasound (cUS) have been reported in infants born to mothers with autoimmune disease. However, the pathogenesis of the infants' brain injury remains unclear. The authors aimed to study the possible association between abnormalities on neonatal cUS and perinatal factors related to maternal autoimmune disease.

METHODS

cUS evaluation was carried out at birth in 114 infants born to mothers with autoimmune disease, and repeated up to 8-9 months of life in those showing sonographic abnormalities at the first examination. The authors analysed the relationships among cerebral ultrasound abnormalities and antenatal exposure to maternal drug treatment, placental transfer of auto-antibodies and gestational complications. In addition, infants were investigated for neuromotor development from birth to 24 months of age.

RESULTS

Cerebral ultrasound abnormalities, including subependymal pseudocyst, lenticulostriate vasculopathy and echogenic periventricular white matter, were detected in 41 of 114 infants (35.9%). No significant associations were found between abnormalities on cUS and the perinatal factors included in the study. No cases of persistent cerebral ultrasound abnormalities or neuromotor delay were observed during the follow-up period.

CONCLUSIONS

A considerable number of cerebral ultrasound abnormalities were observed in a cohort of infants born to mothers with autoimmune disease. However, no perinatal factors were significantly associated with this finding, suggesting the fetal brain impairment had a multi-factorial aetiology. Although no case of neuromotor delay was observed, long term neurological assessment of these babies is recommended in view of the cognitive impairment reported in previous studies.