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Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern.

AbstractOBJECTIVE:
Congenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10-20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort.
METHODS:
The influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies.
RESULTS:
There was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity did not influence the development of heart block in either group. Maternal age in Ro/La-positive pregnancies with a child affected by heart block was, however, significantly higher than in pregnancies resulting in babies without heart block (p<0.05).Seasonal timing of pregnancy influenced the outcome. Gestational susceptibility weeks 18-24 occurring during January-March correlated with a higher proportion of children with heart block and lower vitamin D levels during the same period in a representative sample of Swedish women and a corresponding higher proportion of children with heart block born in the summer (p<0.02). Maternal age or seasonal timing of pregnancy did not affect the outcome in Ro/La-negative pregnancies.
CONCLUSION:
This study identifies maternal age and seasonal timing of pregnancy as novel risk factors for heart block development in children of Ro/La-positive women. These observations may be useful for counselling when pregnancy is considered.
AuthorsAurélie Ambrosi, Stina Salomonsson, Håkan Eliasson, Elisabeth Zeffer, Amanda Skog, Vijole Dzikaite, Gunnar Bergman, Eva Fernlund, Joanna Tingström, Elke Theander, Annika Rydberg, Thomas Skogh, Annika Öhman, Ulla Lundström, Mats Mellander, Ola Winqvist, Michael Fored, Anders Ekbom, Lars Alfredsson, Henrik Källberg, Tomas Olsson, Fredrik Gadler, Anders Jonzon, Ingrid Kockum, Sven-Erik Sonesson, Marie Wahren-Herlenius
JournalAnnals of the rheumatic diseases (Ann Rheum Dis) Vol. 71 Issue 3 Pg. 334-40 (Mar 2012) ISSN: 1468-2060 [Electronic] England
PMID21953338 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Antinuclear
  • SS-A antibodies
  • SS-B antibodies
  • Vitamin D
Topics
  • Adolescent
  • Adult
  • Antibodies, Antinuclear (blood)
  • Autoimmune Diseases (epidemiology, immunology)
  • Birth Order
  • Child
  • Child, Preschool
  • Family Characteristics
  • Female
  • Heart Block (congenital, epidemiology, immunology)
  • Humans
  • Infant
  • Infant, Newborn
  • Maternal Age
  • Parity
  • Pregnancy
  • Pregnancy Complications (epidemiology, immunology)
  • Prenatal Exposure Delayed Effects
  • Recurrence
  • Risk Factors
  • Seasons
  • Sex Factors
  • Sweden (epidemiology)
  • Vitamin D (blood)
  • Young Adult

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