TY - JOUR T1 - Factors associated with long-term cardiac dysfunction in neonatal lupus JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 217 LP - 224 DO - 10.1136/annrheumdis-2019-215900 VL - 79 IS - 2 AU - Amit Saxena AU - Peter M Izmirly AU - Rebecca P Bomar AU - Rachel Shireen Golpanian AU - Deborah M Friedman AU - Ruth Eisenberg AU - Mimi Y Kim AU - Jill P Buyon Y1 - 2020/02/01 UR - http://ard.bmj.com/content/79/2/217.abstract N2 - Objectives Cardiac manifestations of neonatal lupus (NL) have been associated with significant morbidity and mortality; however, there is minimal information on long-term outcomes of affected individuals. This study was initiated to evaluate the presence of and the risk factors associated with cardiac dysfunction in NL after birth in multiple age groups to improve counselling, to further understand pathogenesis and to provide potential preventative strategies.Methods Echocardiogram reports were evaluated in 239 individuals with cardiac NL: 143 from age 0–1 year, 176 from age >1–17 years and 64 from age >17 years. Logistic regression analyses evaluated associations of cardiac dysfunction at each age group with demographic, fetal and postnatal factors, using imputation to address missing data.Results Cardiac dysfunction was identified in 22.4% at age 0–1 year, 14.8% at age >1–17 years and 28.1% at age >17 years. Dysfunction in various age groups was significantly associated with male sex, black race, lower fetal heart rates, fetal extranodal cardiac disease and length of time paced. In 106 children with echocardiograms at ages 0–1 year and >1–17 years, 43.8% with dysfunction at age 0–1 year were also affected at age >1–17 years, while the others reverted to normal. Of children without dysfunction at age 0–1 year, 8.9% developed new dysfunction between ages >1 and 17 years. Among 34 with echocardiograms at ages >1–17 years and >17 years, 6.5% with normal function at age >1–17 years developed dysfunction in adulthood.Conclusions Risk factors in fetal life can influence cardiac morbidity into adulthood.Although limited by a small number of cases, cardiac dysfunction in the first year often normalises by later childhood. New-onset dysfunction, although rare, can occur de novo after the first year. ER -