Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Outcome of infants from mothers with anti-SSA/Ro antibodies

Journal of Perinatology volume 27, pages 278–283 (2007)Cite this article

Abstract

Objective:

To evaluate the incidence of electrocardiographic and laboratory abnormalities in neonates born from mothers with connective tissue disease and positive for anti-SSA/Ro antibodies.

Study Design:

Electrocardiogram, blood cell counts, liver and renal function tests prospectively obtained from 51 infants born from anti-SSA/Ro-positive mothers with connective tissue disease were compared with those obtained from 50 control infants born from mothers with anti-extractable nuclear antigen (ENA)-negative connective tissue disease. One infant with congenital complete heart block was excluded from analysis.

Results:

No infant showed sinus bradycardia. A first-degree atrioventricular block at birth was observed in five study group and no control group infants, P=0.023. Atrioventricular blocks spontaneously reverted or remained stable during the first year of life. Mean corrected QT value of infants born from anti-SSA/Ro-positive mothers was slightly prolonged as compared with the control group (0.404±0.03 s vs 0.395±0.02 s; P=0.060).

Conclusions:

Infants exposed to anti-SSA/Ro antibodies had a significantly higher prevalence of first-degree atrioventricular block. At variance with previous studies, we observed a low frequency of hematologic abnormalities and no cases of hepatobiliary disease.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Michaelsson M, Engle MA . Congenital complete heart block: an international study of the natural history. Cardiovasc Clin 1972; 4: 85–101.

    CAS  PubMed  Google Scholar 

  2. Scott JS, Maddison PJ, Taylor PV, Esscher E, Scott O, Skinner RP . Connective-tissue disease, antibodies to ribonucleoprotein, and congenital heart block. N Engl J Med 1983; 309: 209–212.

    Article  CAS  PubMed  Google Scholar 

  3. Manthorpe T, Manthorpe R . Congenital complete heart block in children of mothers with primary Sjogren's syndrome. Lancet 1992; 340: 1359–1360.

    Article  CAS  PubMed  Google Scholar 

  4. Ramsey-Goldman R, Hom D, Deng JS, Ziegler GC, Kahl LE, Steen VD et al. Anti–SSA antibodies and fetal outcome in maternal systemic lupus erythematosus. Arthritis Rheum 1986; 29: 1269–1273.

    Article  CAS  PubMed  Google Scholar 

  5. Buyon JP, Hiebert R, Copel J, Craft J, Friedman D, Katholi M et al. Autoimmune-associated congenital heart block: mortality, morbidity, and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol 1998; 31: 1658–1666.

    Article  CAS  PubMed  Google Scholar 

  6. Brucato A, Frassi M, Franceschini F, Cimaz R, Faden D, Pisoni MP et al. Congenital heart block risk to newborns of mothers with anti-Ro/SSA antibodies detected by counterimmunoelectrophoresis. A prospective study of 100 women. Arthritis Rheum 2001; 44: 1832–1835.

    Article  CAS  PubMed  Google Scholar 

  7. Waltuck J, Buyon JP . Autoantibody-associated congenital heart block: outcome in mothers and children. Ann Intern Med 1994; 120: 544–551.

    Article  CAS  PubMed  Google Scholar 

  8. Neiman AR, Lee LA, Weston WL, Buyon JP . Isolated cutaneous manifestations of neonatal lupus: characteristics of mothers and children enrolled in a national registry. J Pediatr 2000; 137: 674–680.

    Article  CAS  PubMed  Google Scholar 

  9. Cimaz R, Spence DL, Hornberger L, Silverman ED . Incidence and spectrum of neonatal lupus erythematous: a prospective study of infant born to mothers with anti-Ro antibodies. J Pediatr 2003; 142: 678–683.

    Article  PubMed  Google Scholar 

  10. Lee LA, Sokol RJ, Buyon JP . Hepatobiliary disease in neonatal lupus: prevalence and clinical characteristics in cases enrolled in a national registry. Pediatrics 2002; 109: E11.

    Article  PubMed  Google Scholar 

  11. Cimaz R, Airoldi ML, Careddu P, Centinaio G, Catelli L, Franceschini F et al. Transient neonatal bradycardia without heart block associated with anti-Ro antibodies [letter]. Lupus 1997; 6: 487–488.

    Article  CAS  PubMed  Google Scholar 

  12. Brucato A, Cimaz R, Catelli L, Meroni PL . Anti-Ro associated sinus bradycardia in newborns [letter]. Circulation 2000; 102: E88–E89.

    Article  CAS  PubMed  Google Scholar 

  13. Cimaz R, Stramba-Badiale M, Brucato A, Catelli L, Panzeri P, Meroni PL . QT interval prolongation in asymptomatic anti-SSA/Ro-positive infants without congenital heart block. Arthritis Rheum 2000; 43: 1049–1053.

    Article  CAS  PubMed  Google Scholar 

  14. Gordon PA, Khamashta MA, Hughes GRV, Rosenthal E . Increase in the heart rate-corrected QT interval in children of anti-Ro-positive mothers, with a further increase in those with siblings with congenital heart block: comment on the article by Cimaz et al. [letter]. Arthritis Rheum 2001; 44: 242–243.

    Article  CAS  PubMed  Google Scholar 

  15. Cimaz R, Meroni PL, Brucato A, Fesstova V, Panzeri P, Goulene K et al. Concomitant disappearance of electrocardiographic abnormalities and of acquired maternal autoantibodies during the first year of life in infants who had QT interval prolongation and anti-SSA/Ro positivity without congenital heart block at birth. Arthritis Rheum 2003; 48: 266–268.

    Article  PubMed  Google Scholar 

  16. Askanase AD, Friedman DM, Copel J, Dische MR, Dubin A, Starc TJ et al. Spectrum and progression of conduction abnormalities in infants born to mothers with anti-SSA/Ro-SSB/La antibodies. Lupus 2002; 11: 145–151.

    Article  CAS  PubMed  Google Scholar 

  17. Sonesson SE, Salomonsson S, Jacobsson LA, Bremme K, Wahren-Herlenius M . Signs of first-degree heart block occur in one-third of fetuses of pregnant women with anti-SSA/Ro 52-kd antibodies. Arthritis Rheum 2004; 50: 1253–1261.

    Article  CAS  PubMed  Google Scholar 

  18. Vesel S, Mazic U, Blejec T, Podnar T . First-degree heart block in the fetus of an anti-SSA/Ro-positive mother: reversal after a short course of dexamethasone treatment. Arthritis Rheum 2004; 50: 2223–2226.

    Article  PubMed  Google Scholar 

  19. Gerosa M, Cimaz R, Golene K, Stramba-Badiale M, Trespidi L, Tincani A et al. Electrocardiographic abnormalities in babies of anti-Ro/La positive mothers: a prospective study. 2005 69th annual meeting of the American College of Rheumatology [abstract].

  20. Clark G, Reichlin M, Tomasi Jr TB . Characterization of a soluble cytoplasmic antigen reactive with sera from patients with systemic lupus erythmatosus. J Immunol 1969; 102: 117–122.

    CAS  PubMed  Google Scholar 

  21. Manroe BL, Weinberg AG, Rosenfeld CR, Browne R . The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95: 89–98.

    Article  CAS  PubMed  Google Scholar 

  22. Weinberg AG, Rosenfeld CR, Manroe BL, Browne R . Neonatal blood cell count in health and disease. II. Values for lymphocytes, monocytes, and eosinophils. J Pediatr 1985; 106: 462–466.

    Article  CAS  PubMed  Google Scholar 

  23. Blanchette V, Zipursky A . Assessment anemia in newborn infants. Clin Perinatol 1984; 11: 489–516.

    Article  CAS  PubMed  Google Scholar 

  24. Davignon A, Rautaharju P, Boiselle E, Soumis F, Megela M, Choquette A . Normal ECG standards for infants and children. Pediatr Cardiol 1979; 1: 123–152.

    Article  Google Scholar 

  25. Schwartz PJ, Garson Jr A, Paul T, Stramba-Badiale M, Vetter VL, Wren C, for the European Society of Cardiology. Guidelines for the interpretation of the neonatal electrocardiogram. Eur Heart J 2002; 23: 1329–1344.

    Article  CAS  PubMed  Google Scholar 

  26. Buyon JP, Kim MY, Copel JA, Friedman DM . Anti-Ro/SSA antibodies and congenital heart block: necessary but not sufficient. Arthritis Rheum 2001; 44: 1723–1727.

    Article  CAS  PubMed  Google Scholar 

  27. Costedoat-Chalumeau N, Amoura Z, Lupoglazoff JM, Thi Huong DL, Denjoy I, Vauthier D et al. Outcome of pregnancies in patients with anti-SSA/Ro antibodies. Arthritis Rheum 2004; 50: 3187–3194.

    Article  PubMed  Google Scholar 

  28. Schwartz PJ, Montemerlo M, Facchini M, Salice P, Rosti D, Poggio G et al. The QT interval throughout the first 6 months of life: a prospective study. Circulation 1982; 66: 496–501.

    Article  CAS  PubMed  Google Scholar 

  29. Costedoat-Chalumeau N, Hulot JS, Amoura Z, Delcourt A, Maisonobe T, Dorent R et al. Cardiomyopathy related to antimalarial therapy with illustrative case report. Cardiology 2006; 107: 73–80.

    Article  PubMed  Google Scholar 

  30. Comin-Colet J, Sanchez-Corral MA, Alegre-Sancho JJ, Valverde J, Lopez-Gomez D, Sabate X et al. Complete heart block in an adult with systemic lupus erythematosus and recent onset of hydroxychloroquine therapy. Lupus 2001; 10: 59–62.

    Article  CAS  PubMed  Google Scholar 

  31. Chirico G, Motta M, Villani P, Cavazza A, Cardone ML . Late-onset neutropenia in very low birthweight infants. Acta Paediatr Suppl 2002; 438: 104–108.

    Article  Google Scholar 

  32. Kaplan MJ, Lewis EE, Shelden EA, Somers E, Pavlic R, McCune WJ et al. The apoptotic ligands TRAIL, TWEAK, and Fas ligand mediate monocyte death induced by autologous lupus T cells. J Immunol 2002; 169: 6020–6029.

    Article  CAS  PubMed  Google Scholar 

  33. Matsuyama W, Yamamoto M, Higashimoto I, Oonakahara K, Watanabe M, Machida K et al. TNF-related apoptosis-inducing ligand is involved in neutropenia of systemic lupus erythematosus. Blood 2004; 104: 184–191.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neonatology and NICU, Spedali Civili-Brescia, Italy

    M Motta, C Rodriguez-Perez & G Chirico

  2. Department of Rheumatology and Clinical Immunology, University of Brescia, Spedali Civili-Brescia, Italy

    A Tincani

  3. Department of Obstetrics and Gynecology, Spedali Civili-Brescia, Italy

    A Lojacono

Authors
  1. M Motta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C Rodriguez-Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Tincani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Lojacono
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G Chirico
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Motta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Motta, M., Rodriguez-Perez, C., Tincani, A. et al. Outcome of infants from mothers with anti-SSA/Ro antibodies. J Perinatol 27, 278–283 (2007). https://doi.org/10.1038/sj.jp.7211688

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211688

Keywords

This article is cited by

Search

Advanced search

Quick links