Pregnancy outcome in 100 women with autoimmune diseases and anti-Ro/SSA antibodies: a prospective controlled study.
Anti-Ro/SSA antibodies are associated with neonatal lupus but are also considered a possible cause for unexplained pregnancy loss and adverse pregnancy outcome. In a large multicentres cohort study we have prospectively followed 100 anti-Ro/SSA positive women (53 systemic lupus erythematosus (SLE)) during their 122 pregnancies and 107 anti-Ro/SSA negative women (58 SLE) (140 pregnancies). Anti-Ro/SSA antibodies were tested by immunoblot and counterimunoelectrophoresis. Mean gestational age at delivery (38 vs 37.9 weeks), prevalence of pregnancy loss (9.9 vs 18.6%), preterm birth (21.3 vs 13.9%), cesarean sections (49.2 vs 53.4%), premature rupture of membranes (4.9 vs 8.1%), preeclampsia (6.6 vs 8%), intrauterine growth retardation (0 vs 2.3%)and newborns small for gestational age (11.5 vs 5.8%) were similar in anti-Ro/SSA positive and negative SLE mothers; findings were similar in non-SLE women. Two cases of congenital heart block were observed out of 100 anti-Ro/SSA positive women. In conclusion, anti-Ro/SSA antibodies are responsible for congenital heart block but do not affect other pregnancy outcomes, both in SLE and in non-SLE women. The general outcome of these pregnancies is now very good, ifprospectively followed by multidisciplinary teams with ample experience in this field.
Brucato
A
A
abrucato@ospedale-niguarda.it
Doria
A
A
Frassi
M
M
Castellino
G
G
Franceschini
F
F
Faden
D
D
Pisoni
M Pia
MP
Solerte
L
L
Muscarà
M
M
Lojacono
A
A
Motta
M
M
Cavazzana
I
I
Ghirardello
A
A
Vescovi
F
F
Tombini
V
V
Cimaz
R
R
Gambari
P F
PF
Meroni
P L
PL
Canesi
B
B
Tincani
A
A
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D000918:Antibody Specificity; D005260:Female; D006327:Heart Block / Q000151:congenital / Q000453:epidemiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000276:immunology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012859:Sjogren's Syndrome / Q000150:complications* / Q000453:epidemiology / Q000276:immunology
D000974:Antibodies, Antinuclear; C035356:SS-A antibodies