ResearchObstetricsMaternal autoantibody levels in congenital heart block and potential prophylaxis with antiinflammatory agents
Section snippets
Materials and Methods
This study was approved by the Duke University Hospital Institutional Review Board. Subjects were identified by reviewing the outpatient schedule and records from our fetal cardiology clinic and affiliated community pediatric cardiology clinics from 2007 through 2011. Records from our rheumatology and maternal-fetal medicine clinics were also reviewed for supplemental information. All pregnant women who were positive for anti-Ro/SSA antibodies and serially screened via fetal echocardiography
Results
In all, 33 subjects were followed up at our institution during the study period. Maternal information is summarized in Table 1. Average subject age was 29.2 years. In all, 61% (n = 20) had a diagnosis of systemic lupus erythematosus. Other rheumatologic diagnoses included unspecified rheumatologic disease (n = 8, 24%), Sjögren syndrome (n = 3, 9%), spondyloarthritis with associated Crohn's disease and autoimmune neutropenia (n = 1, 3%), and rheumatoid arthritis (n = 1, 3%). An average of 9
Comment
The results of this study suggest that maternal therapy with antiinflammatory agents throughout pregnancy may provide a protective effect against the development of congenital heart block. Once complete fetal heart block develops, it is irreversible and leads to significant morbidity and potential mortality for the infant.15, 16, 17 It has been demonstrated that the fetal rhythm can rapidly and dramatically change from normal AV conduction to complete heart block in a matter of days.18 The
Acknowledgments
We would like to thank Donna Bouser, analytical specialist in the immunology laboratory, for her assistance in obtaining maternal antibody level data. We also thank Robin Wilson, RN, and Tracy Fukes, RN, in the pediatric echo laboratory for their assistance in patient identification. No compensation was provided to these individuals for their efforts.
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2019, Revue du Rhumatisme (Edition Francaise)M281, an anti-FcRn antibody, inhibits IgG transfer in a human ex vivo placental perfusion model
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Pregnancy in patients with systemic lupus erythematosus: a systematic review
2023, Archives of Gynecology and Obstetrics
The authors report no conflict of interest.
Cite this article as: Tunks RD, Clowse MEB, Miller SG, et al. Maternal autoantibody levels in congenital heart block and potential prophylaxis with antiinflammatory agents. Am J Obstet Gynecol 2013;208:64.e1-7.