Abstract
Objective
The factors associated with the development of cardiac manifestations of neonatal
lupus (cardiac-NL) in fetuses with positive anti-SSA/Ro and/or SSB/La (anti-SSA/SSB)
antibodies are unclear. This study aimed to investigate the predictive factors of
fetal cardiac-NL in anti-SSA/SSB antibody-positive pregnant women.
Study Design
A total of 669 pregnant women with positive anti-SSA/SSB antibodies were retrospectively
included. We determined whether the fetus had cardiac-NL and collected relevant clinical
data. Univariate and multivariate analyses were performed to analyze the correlation
between fetal cardiac-NL and clinical characteristics.
Results
Among 669 pregnant women with positive anti-SSA/SSB antibody tests, 26 cases of fetal
cardiac-NL occurred. Univariate analysis showed that fetal cardiac-NL was positively
correlated with the assisted reproduction (odds ratio [OR]: 2.824; p = 0.045), strong positive anti-SSA/SSB antibody (OR: 6.437; p < 0.001), and clinical diagnosis of connective tissue disease (CTD; OR: 4.701; p = 0.037); it was negatively correlated with the use of hydroxychloroquine (HCQ; OR:
0.187; p < 0.001) and aspirin (OR: 0.369; p = 0.048). Multivariate analysis showed that the assisted reproduction (OR: 4.110;
p = 0.029), strong positive anti-SSA/SSB antibody (OR: 8.691; p < 0.001), and clinical diagnosis of CTD (OR: 8.614; p = 0.010) were risk factors for fetal cardiac-NL; while HCQ (OR: 0.091; p < 0.001) and aspirin (OR: 0.318; p = 0.035) were protective factors for fetal cardiac-NL.
Conclusion
This study determined that assisted reproduction, strong positive anti-SSA/SSB antibody,
and clinical diagnosis of CTD are independent risk factors for fetal cardiac-NL. The
use of HCQ and aspirin are independent protective factor for fetal cardiac-NL.
Key Points
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Anti-SSA/SSB antibodies can lead to fetal cardiac-NL.
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Assisted reproduction, strong positive anti-SSA/SSB antibodies, and CTD are risk factors.
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HCQ and aspirin use may lower the risk of fetal cardiac-NL.
Keywords
anti-SSA/Ro - SSB/La antibody - fetal - neonatal lupus - cardiac manifestations -
predictive factors
