Ethnicity and Neonatal Lupus Erythematosus Manifestations Risk in a Large Multi-Ethnic Cohort.

Abstract

OBJECTIVE\nTo evaluate the association between ethnicity and neonatal lupus erythematosus (NLE), as well as specific NLE manifestations in a large multi-ethnic population.\n\n\nMETHODS\nWe conducted a cohort study of the children (≤1 year of age) seen in the NLE clinic at SickKids, between January 2011 and April 2019. The cohort was divided into European, non-European and Mixed European-Non-European groups according to parent reported child s ethnicity (Canada census categories). Outcomes were NLE and specific NLE manifestations (cardiac, cutaneous, cytopenias, transaminitis and macrocephaly). The frequency of NLE and specific manifestations were compared between ethnic groups (Fisher s exact test). We tested the association between ethnicity and 1) NLE risk and 2) specific NLE manifestations with logistic regression models, including covariates for child s sex, maternal rheumatic disease status during pregnancy, and maternal use of antimalarials during pregnancy (multiple comparisons threshold p-value<0.008).\n\n\nRESULTS\nWe included 324 children born to 270 anti-Ro antibody positive mothers. Median age at first visit: 1.8 months (IQR: 1.4, 2.3 months). Median follow-up time: 12 months (IQR: 2,24months). The majority were non-European (48%), with 34% European, and 18% Mixed European-Non-European. There was no significant association between non-European ethnicity (OR 1.14, 95% CI:0.69-1.89, p=0.59), Mixed European-Non-European ethnicity (OR 1.06, 95% CI:0.55-2.06, p=0.84) and NLE risk compared with European ethnicity. We also did not find an association between ethnicity and specific NLE manifestations, in univariate or multivariable adjusted models.\n\n\nCONCLUSION\nIn a large multiethnic cohort, there was no association between child s ethnicity and NLE risk, nor specific NLE manifestations.