ArticleArthritis care & research2013
In utero azathioprine exposure and increased utilization of special educational services in children born to mothers with systemic lupus erythematosus.
Article in Arthritis care & research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 50 citations in OpenAlex.
- Maternal systemic autoimmune rheumatic diseases and childhood mental disorders: a nationwide cohort study.Lupus science & medicine · 2026Article
- The long-term development outcomes of the offspring born to patients with systemic lupus erythematosus: a cross-sectional study.European child & adolescent psychiatry · 2025Article
- Offspring neurodevelopmental outcomes born to parents with chronic inflammatory arthritis using antirheumatic therapies: A scoping review.Seminars in arthritis and rheumatism · 2023Article
- [Research progress on long-term developmental outcomes of offspring of pregnant women with systemic lupus erythematosus].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- Outcomes of children born to mothers with systemic lupus erythematosus exposed to hydroxychloroquine or azathioprine.Rheumatology (Oxford, England) · 2023Article
- Prenatal Drug Exposure in Children With a History of Neuropsychiatric Care: A Nested Case-Control Study.Frontiers in psychiatry · 2022Article
- Neuropsychiatric Outcome of Children Born to Women With Systemic Lupus Erythematosus and ExposedFrontiers in pharmacology · 2020Article
- Systemic Lupus Erythematosus Presenting as Acute Lupus Pneumonitis during Pregnancy.Case reports in rheumatology · 2020Article
- Detection of epitopes in systemic lupus erythematosus using peptide microarray.Molecular medicine reports · 2018Article
- Neonatal and Obstetrical Outcomes of Pregnancies in Systemic Lupus Erythematosus.Oman medical journal · 2018Article
- Screening epitopes on systemic lupus erythematosus autoantigens with a peptide array.Oncotarget · 2017Article
- Pregnancy and autoimmune connective tissue diseases.Best practice & research. Clinical rheumatology · 2016Review
- Systemic lupus erythematosus: strategies to improve pregnancy outcomes.International journal of women's health · 2016Review
- Azathioprine during pregnancy in systemic lupus erythematosus patients is not associated with poor fetal outcome.Clinical rheumatology · 2015Article
- Increased usage of special educational services by children born to mothers with systemic lupus erythematosus and antiphospholipid antibodies.Lupus science & medicine · 2014Article
- Lupus science and medicine: dialogue.Lupus science & medicine · 2014Article
- Managing lupus patients during pregnancy.Best practice & research. Clinical rheumatology · 2013Review
- Systemic lupus erythematosus and pregnancy.Rheumatic diseases clinics of North America · 1994Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveAzathioprine (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.
methodsThis cohort study included SLE patients with at least one live birth postdiagnosis. 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.
resultsOf 60 eligible offspring from 38 mothers, 15 required SE services, the most common indication for which was speech delay. Seven (54%) of the 13 children with in utero AZA exposure utilized SE services versus 8 (17%) of 47 nonexposed children (P < 0.01). After adjustment for pregnancy duration, small for gestational age, propensity score, maternal education level, and antiphospholipid antibody syndrome, AZA was significantly associated with SE utilization occurring from age 2 years onward (odds ratio 6.6, 95% confidence interval 1.0-43.3), and bordered on significance for utilization at any age or age <2 years.
conclusionAZA 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.
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