Higher maternal anti-Ro and anti-La antibody levels were significantly associated with fetal congenital heart block, with median anti-Ro levels of 240 in affected versus 42 in unaffected pregnancies.
Cohort (n=182)
No
Are higher maternal anti-Ro and anti-La antibody levels associated with an increased risk of congenital heart block in fetuses of seropositive pregnant women?
Higher quantitative maternal anti-Ro and anti-La antibody levels are significantly associated with an increased risk of fetal congenital heart block, highlighting the importance of antibody burden in risk stratification.
Absolute Event Rate: 240% vs 42%
p-value: p=<0.001
Abstract Objective To evaluate the association between maternal anti-Ro and anti-La antibody levels and the occurrence of congenital heart block (CHB) in fetuses and newborns. Methods This retrospective cohort study included 182 pregnant women with positive anti-Ro and/or anti-La antibodies who received prenatal care at our tertiary center between 2002 and 2022. Maternal clinical, laboratory, and obstetric variables were analyzed. Results Thirteen fetuses (7.1%) were diagnosed with CHB. Mothers of affected fetuses had significantly higher anti-Ro (median 240 vs. 42; p < 0.001) and anti-La (median 150 vs. 10; p < 0.001) levels. Anti-La positivity was more frequent in the CHB group (76.9% vs. 42.6%; p = 0.017). Lower complement C4 levels ( p = 0.008) and disease duration of less than 1 year since diagnosis ( p = 0.008) were also associated with CHB. Preconception hydroxychloroquine and prednisone use were less frequent in affected pregnancies ( p = 0.044 and p = 0.039, respectively). Conclusion Higher maternal anti-Ro and anti-La antibody levels were significantly associated with fetal CHB. Preconception hydroxychloroquine may provide a protective effect. Early diagnosis and specialized care are essential for optimizing neonatal outcomes.
Pannain et al. (Sat,) conducted a cohort in Pregnancy with positive anti-Ro and/or anti-La antibodies (n=182). Maternal anti-Ro and anti-La antibodies vs. Lower maternal antibody levels was evaluated on Median maternal anti-Ro antibody levels in pregnancies with fetal congenital heart block (p=<0.001). Higher maternal anti-Ro and anti-La antibody levels were significantly associated with fetal congenital heart block, with median anti-Ro levels of 240 in affected versus 42 in unaffected pregnancies.