Maternal autoantibody levels in congenital heart block and potential prophylaxis with antiinflammatory agents

详细信息    查看全文

• 作者：Robert D. Tunks ; MD^a ; Megan E.B. Clowse ; MD ; MPH^b ; Stephen G. Miller ; MD^a ; Leo R. Brancazio ; MD^c ; Piers C.A. Barker ; MD^a ; ^{piers.barker@dm.duke.edu}
• 关键词：autoantibodies ; congenital heart block ; fetal echocardiography ; prevention
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：208
• 期：1
• 页码：64.e1-64.e7
• 全文大小：527 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Objective

The importance of maternal autoantibody levels in congenital heart block and elucidation of maternal factors that may reduce disease burden require further clarification.

Study Design

Pregnancies complicated by maternal anti-Ro antibodies from 2007 through 2011 were retrospectively reviewed.

Results

In all, 33 women were followed up throughout pregnancy. Semiquantitative maternal anti-La levels were significantly higher in pregnancies complicated by fetal heart block of any degree (median difference, 227.5; P = .04), but there was no difference in maternal anti-Ro levels. In all, 94 % of fetuses maintained normal conduction when the mother was treated with hydroxychloroquine or daily prednisone therapy throughout pregnancy, compared to 59 % in the untreated group (odds ratio, 0.1; P = .04).

Conclusion

Pregnancies complicated by fetal heart block did not have higher levels of maternal anti-Ro antibodies. Maternal anti-La level may be a useful predictor of fetal heart block. Maternal treatment with either hydroxychloroquine or daily low-dose prednisone throughout pregnancy may provide a protective effect.