title: Incidence and spectrum of neonatal lupus erythematosus: a prospective study of infants born to mothers with anti-Ro autoantibodies.
abstract: OBJECTIVE
  Neonatal lupus erythematosus (NLE) is characterized by complete congenital heart block (CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with autoantibodies directed against SSA/Ro, SSB/La, or both. We carried out a prospective study to determine the incidence of individual NLE features.
  
  
  METHODS
  The study was performed in two centers: Toronto, Canada, and Milano, Italy. Mothers had been referred for the presence of anti-SSA/Ro autoantibodies, regardless of their diagnosis. All the children were seen at least once within the first 6 months of life for clinical evaluation and laboratory testing. The study group consisted of 128 infants born from 124 pregnancies in 112 women with anti-Ro antibodies with or without anti-La antibodies.
  
  
  RESULTS
  There were two cases of CCHB for an overall percentage of 1.6%. Twenty-one children (16%) developed cutaneous NLE. Laboratory testing showed hematologic abnormalities in 27% of the babies and elevation of liver enzymes in 26%.
  
  
  CONCLUSIONS
  Mothers with autoimmune diseases and anti-Ro antibodies are at risk of delivering a child with NLE but at a low risk of delivering a child with CCHB. Infants born to mothers with anti-Ro or anti-La antibodies should be monitored for other features of NLE in addition to CCHB.
authors.affiliation: Pediatric Department, ICP, Milano, Italy. Rolando.Cimaz@unimi.it
authors.forename: Rolando
authors.initials: R
authors.lastname: Cimaz
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Spence
authors.forename: Lisa
authors.initials: L
authors.lastname: Hornberger
authors.forename: Earl D
authors.initials: ED
authors.lastname: Silverman
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D001324:Autoantigens / Q000276:immunology*; D001327:Autoimmune Diseases / Q000276:immunology*; D005260:Female; D006327:Heart Block / Q000151:congenital* / Q000276:immunology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*; D011446:Prospective Studies; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins / Q000276:immunology*; D000099207:SS-A Antigen
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins; D000099207:SS-A Antigen; C116006:RO60 protein, human