Outcome and growth of infants fetally exposed to heart block-associated maternal anti-Ro52/SSA autoantibodies.

Abstract

OBJECTIVE:

The purpose of this work was to analyze outcome with focus on growth in infants fetally exposed to heart block-associated maternal anti-Ro52/SSA autoantibodies and identify maternal factors other than the autoantibodies increasing the risk of fetal heart block.

PATIENTS AND METHODS:

Thirty-two pregnancies in 30 anti-Ro52-positive mothers were included. Seven fetuses developed second-degree or third-degree atrioventricular block, 8 developed first-degree atrioventricular block, and 17 had normal atrioventricular conduction, as diagnosed by using Doppler echocardiography. Three of 6 surviving fetuses with second-degree or third-degree atrioventricular block received treatment with fluorinated steroids. Two fetuses with second-degree atrioventricular block converted to first-degree atrioventricular block without any signs of progression during the study period. Maternal and longitudinal infant data were collected from planned neonatal follow-up and childhood health records from birth to 12 months of age in 31 survivors.

RESULTS:

Women giving birth to infants with prenatal second-degree or third-degree atrioventricular block were older and with higher parity than those with first-degree atrioventricular block or normal atrioventricular conduction. Second-degree or third-degree atrioventricular block pregnancies were <40 completed weeks, whereas pregnancies with first-degree atrioventricular block or normal atrioventricular conduction had a normal duration. Fetuses with second-degree or third-degree atrioventricular block were retarded by -0.98 +/- 0.77 SD in weight at birth and did not show any catch-up during infancy. In contrast, fetuses with first-degree atrioventricular block or normal atrioventricular conduction had a weight reduction of -0.51 +/- 1.01 SD with a catch-up during the first months after birth.

CONCLUSIONS:

This report documents that newborns with autoantibody-mediated second-degree or third-degree atrioventricular block are retarded in growth, with no catch-up during infancy, whereas fetuses with first-degree atrioventricular block or normal atrioventricular conduction have a normal growth soon after birth. Increased maternal age and/or parity seem to carry an increased risk for fetal heart block.

• Authors: Amanda Skog, Marie Wahren-Herlenius, Birgitta Sundström, Katarina Bremme, Sven-Erik Sonesson
• Journal: Pediatrics (Pediatrics) Vol. 121 Issue 4 Pg. e803-9 (Apr 2008) ISSN: 1098-4275 [Electronic] United States
• PMID: 18381509 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Antinuclear
• Autoantibodies
• Ribonucleoproteins
• SS-A antibodies
• SS-A antigen

Topics

• Antibodies, Antinuclear (blood, immunology)
• Autoantibodies (blood, immunology)
• Cohort Studies
• Female
• Fetal Development (physiology)
• Fetal Diseases (epidemiology, immunology)
• Follow-Up Studies
• Gestational Age
• Heart Block (epidemiology, immunology)
• Humans
• Infant, Newborn
• Male
• Maternal Age
• Parity
• Placental Circulation (immunology)
• Pregnancy
• Pregnancy Complications (epidemiology, immunology)
• Pregnancy Outcome
• Ribonucleoproteins (immunology)
• Risk Factors