| Title | Outcome and growth of infants fetally exposed to heart block-associated maternal anti-Ro52/SSA autoantibodies. | | Author(s) | Skog A, Wahren-Herlenius M, Sundström B, Bremme K, Sonesson SE | | Institution | Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. | | Source | Pediatrics 2008 Apr; 121(4):e803-9. | | MeSH | Antibodies, Antinuclear
Autoantibodies
Cohort Studies
Female
Fetal Development
Fetal Diseases
Follow-Up Studies
Gestational Age
Heart Block
Humans
Infant, Newborn
Male
Maternal Age
Parity
Placental Circulation
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Ribonucleoproteins
Risk Factors
| | 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. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 18381509 |
|
