In 1985, Gualtieri and Hicks proposed the immunoreactive
theory to explain the higher prevalence of childhood neurodevelopmental
disorders in males. The theory claimed that male fetuses
are more antigenic to mothers, resulting in increased immunologic
attack on the developing central nervous system, and increased
probability of atypical brain development. Individuals
with systemic lupus erythematosus (SLE) provide a unique
situation in which to investigate this theory. We evaluated
the parent-reported prevalence of five developmental problems
(stuttering, other speech problems, hyperactivity, attention
deficit, and reading problems) in two groups: 154 individuals
ages 8–20 years born to women with SLE, drawn from
six cities, and 154 controls of comparable age and sex
whose mothers did not have SLE. Controls were drawn from
a comparison group ascertained from randomly selected schools
in one of the cities. Questions about handedness, immune
disorders, and pregnancy and birth complications were also
evaluated. Children of SLE mothers were shown to have more
evidence of developmental difficulties, immune related
disorders, and nonrighthandedness. For developmental problems,
these findings were most marked in male children of SLE
mothers. These results suggest that maternal immunoreactivity,
as represented by women with SLE, may present a special
risk factor for subsequent learning difficulties in their
children, particularly males. (JINS, 1997, 3,
370–376.)