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271 Frequency of neonatal lupus in reference centers in the management of pregnancy and autoimmune diseases
  1. Carla Maldini1,
  2. Cintia Otaduy1,
  3. Florencia Beatriz Mollerach2,
  4. Marina Scolnik2,
  5. Belen Maria Virasoro3,
  6. Cecilia Pisoni3,
  7. Mercedes Croce4,
  8. Maria Hu4,
  9. Fabiola Natalia Camargo Serrudo5,
  10. Diana Dubinsky6,
  11. María de la Paz Leon7,
  12. Veronica Bellomio7,
  13. Daniela Flores Rengifo8,
  14. Eduardo Kerzberg8,
  15. Fernanda Guzzanti9,
  16. Emma E Civit9,
  17. Ana Bertoli10,
  18. Maria Jose Lopez Perez10,
  19. Maximiliano Machado Escobar11,
  20. Veronica Savio12,
  21. Alejandra Babini12,
  22. Cecilia Alvarez13,
  23. Verónica Saurit13,
  24. Rosa Serrano Morales14,
  25. Cruz Lascano15,
  26. María Constanza Danielsen16,
  27. Mayra Etcheverry17,
  28. Adrian Estevez17,
  29. Marina Werner18,
  30. Laura Onetti18,
  31. Paula Alba1 and
  32. Carla Gobbi19
  1. 1Cátedra de Semiología UHMI 3 Hospital Córdoba FCM Universidad Nacional de Córdoba, Córdoba, Argentina
  2. 2Hospital Italiano de Buenos Aires, Argentina
  3. 3Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina
  4. 4Hospital Penna, Buenos Aires, Argentina
  5. 5Rheumatology Division, Sanatorio Guemes
  6. 6Sanatorio Guemes
  7. 7Hospital Padilla, Tucumán, Argentina
  8. 8Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
  9. 9Hospital El Carmen, Mendoza, Argentina
  10. 10Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Córdoba. Argentina
  11. 11Instituto de Maternidad y Ginecologia Nuestra Sra de las Mercedes, Tucuman, Argentina
  12. 12Hospital Italiano, Córdoba, Argentina
  13. 13Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
  14. 14Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR)/Maternidad Oroño, Rosario, Argentina
  15. 15Hospital San Roque, San Salvador de Jujuy, Argentina
  16. 16Clínica del Pilar, Santiago del Estero, Argentina
  17. 17Hospital de Alta Complejidad El Cruce, Buenos Aires, Argentina
  18. 18Hospital Nacional de Clínicas, Córdoba, Argentina
  19. 19Universidad Nacional de Córdoba


Background Neonatal lupus (NL) is a disease in children of mothers who have specific anti-Ro/La IgG autoantibodies by passive transplacental transfer. LN is characterized by skin and cardiac involvement, as well as cytopenias, hepatic or neurological manifestations. NL can be diagnosed intra-uterus or in neonatal period, being self-limiting in several months or be irreversible. Congenital heart block (CHB) in a structurally normal heart, is perhaps the most serious manifestation with an estimated mortality rate of around 19%. Objetives: to estimate the frequency of NL in children of mothers with anti-Ro/La in reference centers in the management of pregnancy and autoimmune diseases in Argentina, and to describe maternal and children features.

Methods A descriptive multicenter study was conducted in reference centers in the management of autoimmune diseases and pregnancy in Argentina. Inclusion criteria were the presence of positive maternal serology anti-Ro/La and at least one pregnancy. Demographic and maternal-fetal clinical data were obtained from the clinical histories and each center completed a data collection form created for this study. We defined a NL case (born or not) who presented, pre and/or postpartum, characteristic skin lesions, cytopenias, cardiac involvement (CHB, endocardial fibroelastosis and dilated cardiomyopathy), hepatic or neurological manifestations. Ethnicity was classified using GLADEL groups. NL frequency was calculated dividing the number NL cases by the number of mothers with positive anti-Ro/La serology.

Results 18 reference centers in the management of autoimmune diseases and pregnancy participated in this study in 7 different geographic areas of Argentina (6 of Buenos Aires, 6 of Cordoba, 1 of Jujuy, 1 of Mendoza, 1 of Santa Fe, 1 of Santiago del Estero and 2 of Tucuman). 193 mothers with positive anti-Ro/La serology were included with 364 pregnancies. 19 cases NL cases were reported (10 diagnosed during pregnancy and 9 in post-partum. The frequency of NL was estimated at 9.8% [95% CI 6.3–14.9] (CHB=6.2% [IC95% 3.5–10.7]). Table 1 describes the maternal and fetal characteristics of NL cases. The most frequent manifestations were skin (n=7) and cardiac involvement (n=12). In 1 case, there was a history of NL in a previous pregnancy. Of the patients with CHB, 5 required a pacemaker.

Abstract 271 Table 1

Maternal and fetal characteristics of the 19 NL cases

Conclusions In conclusion, the frequency of NL in our multicentric cohort is greater than other international cohorts. Differences could be related to genetic/environmental factors as well as methodological limitations and selection bias.

Funding Source(s): None

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