title: Progression to first-degree heart block in preschool children exposed in utero to maternal anti-SSA/Ro52 autoantibodies.
abstract: OBJECTIVE
  To study the children exposed in utero to maternal anti-SSA/Ro52 antibodies in terms of impaired atrioventricular (AV) conduction or disturbed myocardial performance, and to investigate the ability of prenatal Doppler to predict conduction abnormalities during childhood.
  
  
  METHODS
  Fifty-seven children exposed in utero to anti-SSA/Ro52 antibodies were grouped in accordance with (A) prolonged AV time intervals in utero by Doppler or (B) normal findings and examined by ECG, 24-hour ECG and echocardiography.
  
  
  RESULTS
  PR interval on ECG was longer in group A (n = 16) compared with that of group B (n = 41), 140 ± 24 ms vs. 121 ± 13 ms (p < 0.01). Six cases of 1°Atrioventricular block (AVB) developed in group A, giving an estimated prevalence of 10.5%, (95% confidence interval; 4.4-22.2%), progressing from normal sinus rhythm at 1 month of age. Prenatal Doppler predicted development of 1°AVB at follow-up with a sensitivity of 100%, Positive predictive value (PPV) 37.5%, LR+ 5.1, and Negative predictive value (NPV) 100%. Children in group A had a slightly higher myocardial performance index in flow and tissue Doppler imaging recordings.
  
  
  CONCLUSIONS
  Ten per cent of children exposed in utero to anti-SSA/Ro52, with a normal ECG at birth or 1 month of age, progressed to 1°AVB during preschool years. Cases at risk can be identified by prenatal Doppler echocardiography.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Bergman
authors.forename: Håkan
authors.initials: H
authors.lastname: Eliasson
authors.forename: Lilly-Ann
authors.initials: LA
authors.lastname: Mohlkert
authors.forename: Marie
authors.initials: M
authors.lastname: Wahren-Herlenius
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Sonesson
mesh_terms: D001323:Autoantibodies; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000145:classification / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011247:Pregnancy / Q000276:immunology; D011446:Prospective Studies; D012261:Ribonucleoproteins / Q000276:immunology; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D000099207:SS-A Antigen
chemical_list: D001323:Autoantibodies; D012261:Ribonucleoproteins; D000099207:SS-A Antigen