Association Between Maternal Autoantibody Levels and Neurodevelopmental Outcomes in Infants Born to Mothers With Rheumatic Disease.

Abstract

Aims/Background Maternal autoimmune conditions have been associated with adverse pregnancy outcomes and neonatal complications, with potential impacts on fetal neurodevelopment. However, the specific associations between maternal autoantibody levels and neurodevelopmental outcomes in the context of rheumatic diseases remain incompletely understood. Therefore, this study aimed to investigate the relationship between maternal autoantibody profiles and infant neurodevelopmental outcomes in a cohort of mothers with rheumatic diseases, and to evaluate their diagnostic value in predicting neurodevelopmental disorders. Methods This retrospective case-control study included patients admitted for antenatal care with rheumatic conditions from January 2017 to June 2022. Participants were categorised into the normal neurodevelopment group (n = 404) and the neurodevelopmental disorder group (n = 111) based on infant neurodevelopmental outcomes. Maternal cytokines and hormone levels, as well as autoantibody levels, were measured and analysed. Statistical analyses, including correlation and multivariable logistic regression, were employed to evaluate associations between maternal biomarkers and infant neurodevelopmental outcomes. Results Statistically significant differences were observed between the two groups in terms of birth length, maternal cytokine levels (interleukin-6 [IL-6], interleukin-10 [IL-10], interleukin-4 [IL-4]), hormone levels (progesterone, thyroxine), and maternal autoantibody levels (anti-Sjögren's-syndrome-related antigen A [anti-SSA], anti-Sjögren's-syndrome-related antigen B [anti-SSB], anti-double-stranded DNA [anti-dsDNA], anti-ribonucleoprotein [anti-RNP], and anti-Smith [anti-Sm] antibodies) (p < 0.05). Correlation analysis revealed significant associations between specific maternal autoantibodies and neurodevelopmental parameters, as well as a positive correlation between birth length and neurodevelopmental parameters (p < 0.001). The multiple regression model showed that maternal autoantibody levels had a strong diagnostic value for predicting infant neurodevelopment. Conclusion This study provides compelling evidence supporting the relationship between maternal autoantibodies, cytokines, and hormone levels and neurodevelopmental outcomes in infants born to mothers with rheumatic disease.