Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Front Immunol. 2022 Sep 5;13:966809. doi: 10.3389/fimmu.2022.966809. eCollection 2022.
Children of women with systemic lupus erythematosus (SLE) are at risk for childhood-onset SLE (cSLE). This study evaluated the incidence of early-onset cSLE and associated risk factors, including concomitant maternal and paternal autoimmune diseases, for these children.
A population-based cohort study was conducted using national databases including the linked information of children and parents. Children of women with SLE and those of women without SLE were identified between 2004 and 2015. The cumulative cSLE incidence was estimated using the Kaplan-Meier method. The marginal Cox model was used to calculate the hazard ratio (HR) for cSLE events.
A total of 4,419 singletons of women with SLE and 1,996,759 singletons of women without SLE were identified. There were 9 (0.20%) and 503 (0.03%) incident cases of early-onset cSLE for offspring of women with and without SLE, respectively (incidence rate ratio, 8.34; 95% confidence interval [CI], 3.79-15.95]. The adjusted HR of incident cSLE in children of women with SLE was 4.65 (95% CI 2.11-10.24). Other risks for cSLE included pregnancy-induced hypertension/preeclampsia/eclampsia, paternal SLE, paternal Sjögren's syndrome (SS), and maternal SS.
This national child-parent cohort study demonstrated that children of women with SLE are at significantly higher risk for cSLE during early childhood. Moreover, paternal SLE and parental SS increase the risk of cSLE for offspring.
患有系统性红斑狼疮（SLE）的女性所生子女罹患儿童期发病的系统性红斑狼疮（cSLE）的风险较高。本研究评估了这些儿童中早发性 cSLE 的发病情况及其相关危险因素，包括同时存在的母体和父体自身免疫性疾病。
本研究采用了基于人群的队列研究方法，利用包括儿童和父母相关信息的全国性数据库。于 2004 年至 2015 年期间，确定了患有 SLE 的女性及其子女和未患有 SLE 的女性及其子女。采用 Kaplan-Meier 法估计 cSLE 的累积发病率。采用边缘 Cox 模型计算 cSLE 事件的风险比（HR）。
共确定了 4419 名患有 SLE 的女性的单胎子女和 1996759 名未患有 SLE 的女性的单胎子女。患有 SLE 的女性子女中有 9 例（0.20%）和未患有 SLE 的女性子女中有 503 例（0.03%）发生早发性 cSLE（发病率比，8.34；95%置信区间 [CI]，3.79-15.95）。患有 SLE 的女性子女发生 cSLE 的调整 HR 为 4.65（95%CI 2.11-10.24）。cSLE 的其他风险因素包括妊娠高血压/先兆子痫/子痫、父体 SLE、父体干燥综合征（SS）和母体 SS。
本项全国性的母子队列研究表明，患有 SLE 的女性的子女在幼儿期罹患 cSLE 的风险显著增加。此外，父体 SLE 和母体 SS 会增加子女罹患 cSLE 的风险。
