Clinical Reviews in Allergy & Immunology

, Volume 40, Issue 1, pp 27–41

Pregnancy Outcomes in Patients with Autoimmune Diseases and Anti-Ro/SSA Antibodies

  • Antonio Brucato
  • Rolando Cimaz
  • Roberto Caporali
  • Véronique Ramoni
  • Jill Buyon
Article

DOI: 10.1007/s12016-009-8190-6

Cite this article as:
Brucato, A., Cimaz, R., Caporali, R. et al. Clinic Rev Allerg Immunol (2011) 40: 27. doi:10.1007/s12016-009-8190-6
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Abstract

Anti-Ro/SSA antibodies are associated with neonatal lupus (congenital heart block (CHB), neonatal transient skin rash, hematological and hepatic abnormalities), but do not negatively affects other gestational outcomes, and the general outcome of these pregnancies is now good, when followed by experienced multidisciplinary teams. The prevalence of CHB, defined as an atrioventricular block diagnosed in utero, at birth, or within the neonatal period (0–27 days after birth), in the offspring of an anti-Ro/SSA-positive women is 1–2%, of neonatal lupus rash around 10–20%, while laboratory abnormalities in asymptomatic babies can be detected in up to 27% of cases. The risk of recurrence of CHB is ten times higher. Most of the mothers are asymptomatic at delivery and are identified only by the birth of an affected child. Half of these asymptomatic women develop symptoms of a rheumatic disease, most commonly arthralgias and xerophtalmia, but few develop lupus nephritis. A standard therapy for CHB is still matter of investigation, although fluorinated corticosteroids have been reported to be effective for associated cardiomyopathy. Serial echocardiograms and obstetric sonograms, performed at least every 1–2 weeks starting from the 16th week of gestational age, are recommended in anti-Ro/SSA-positive pregnant women to detect early fetal abnormalities that might be a target of preventive therapy.

Keywords

Heart block/congenitalNeonatal lupusAnti-Ro/SSA antibodies

Abbreviations

ANA

Anti-nuclear antibodies

AV

Atrioventricular

CHB

Congenital heart block

ECG

Electrocardiogram

NLS

Neonatal Lupus Syndromes

SLE

Systemic lupus erythematosus

SS

Primary Sjögren’s syndrome

UCTD

Undifferentiated connective tissue disease

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Antonio Brucato
    • 1
  • Rolando Cimaz
    • 2
  • Roberto Caporali
    • 3
  • Véronique Ramoni
    • 1
    • 3
  • Jill Buyon
    • 4
  1. 1.Internal MedicineBergamoItaly
  2. 2.Meyer Children’s Hospital and University of FlorenceFlorenceItaly
  3. 3.Division of RheumatologyUniversity and IRCCS Policlinico San Matteo FoundationPaviaItaly
  4. 4.New York University School of MedicineNew YorkUSA