title: Risk of congenital complete heart block in newborns of mothers with anti-Ro/SSA antibodies detected by counterimmunoelectrophoresis: a prospective study of 100 women.
abstract: OBJECTIVE
  To assess the true prevalence of congenital complete heart block (CCHB) in infants of anti-Ro/SSA-positive women known to have connective tissue disease (CTD) and, secondarily, to evaluate the prevalence of other electrocardiographic abnormalities in these newborns at birth.
  
  
  METHODS
  A prospective study was conducted in 4 referral hospitals. One hundred anti-Ro/SSAA-positive mothers were followed up before they became pregnant and during the index pregnancy. Counterimmunoelectrophoresis and immunoblotting were used to test for antibodies to extractable nuclear antigens.
  
  
  RESULTS
  Of the 100 women with anti-Ro/SSA antibodies, 2 had infants who developed CCHB in utero (2%). The CCHB was detected at 22 weeks and 20 weeks, respectively. One of the 2 mothers had primary Sjögren's syndrome (SS), and the other had undifferentiated CTD (UCTD). No case of CCHB occurred among the infants of 53 mothers with systemic lupus erythematosus (SLE). No fetal death occurred due to CCHB. In 2 centers, electrocardiography was recorded in 24 unselected newborns, and 4 were found to have sinus bradycardia.
  
  
  CONCLUSIONS
  The prevalence of CCHB in newborns of prospectively followed up women already known to be anti-Ro/SSA positive and with known CTD was 2%. This finding is useful with regard to preconception counseling of these women. The risk of delivering an infant with CCHB may be higher in mothers with primary SS or UCTD than in those with SLE. Additional electrocardiographic abnormalities such as sinus bradycardia and prolongation of the QT interval may be present in their children.
authors.affiliation: Niguarda Hospital, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Brucato
authors.forename: M
authors.initials: M
authors.lastname: Frassi
authors.forename: F
authors.initials: F
authors.lastname: Franceschini
authors.forename: R
authors.initials: R
authors.lastname: Cimaz
authors.forename: D
authors.initials: D
authors.lastname: Faden
authors.forename: M P
authors.initials: MP
authors.lastname: Pisoni
authors.forename: M
authors.initials: M
authors.lastname: Muscarà
authors.forename: G
authors.initials: G
authors.lastname: Vignati
authors.forename: M
authors.initials: M
authors.lastname: Stramba-Badiale
authors.forename: L
authors.initials: L
authors.lastname: Catelli
authors.forename: A
authors.initials: A
authors.lastname: Lojacono
authors.forename: I
authors.initials: I
authors.lastname: Cavazzana
authors.forename: A
authors.initials: A
authors.lastname: Ghirardello
authors.forename: F
authors.initials: F
authors.lastname: Vescovi
authors.forename: P F
authors.initials: PF
authors.lastname: Gambari
authors.forename: A
authors.initials: A
authors.lastname: Doria
authors.forename: P L
authors.initials: PL
authors.lastname: Meroni
authors.forename: A
authors.initials: A
authors.lastname: Tincani
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood*; D001324:Autoantigens / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D001919:Bradycardia / Q000175:diagnosis; D003240:Connective Tissue Diseases / Q000276:immunology*; D003378:Counterimmunoelectrophoresis / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000151:congenital* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000276:immunology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins / Q000276:immunology*; D012307:Risk Factors; D000099207:SS-A Antigen
chemical_list: D000974:Antibodies, Antinuclear; D001324:Autoantigens; D015415:Biomarkers; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins; D000099207:SS-A Antigen; C116006:RO60 protein, human