title: Low titer, isolated anti Ro/SSA 60 kd antibodies is correlated with positive pregnancy outcomes in women at risk of congenital heart block.
abstract: Congenital heart block (CHB) is an autoantibody mediated disorder presumably caused by placental transmission of maternal autoantibodies to Ro/SSA 52 kd, p200, Ro/SSA 60 kd, La/SSB ribonucleoproteins. This study investigated the clinical significance of isolated anti-Ro/SSA 52 kd, anti-p200, anti-Ro/SSA 60 kd, and anti-La/SSB antibodies in positive pregnant patients. One hundred sixty-three pregnant women positive to anti-Ro/SSA 52 kd and/or anti-Ro/SSA 60 kd and/or anti-La/SSB antibodies were prospectively enrolled in the study. Anti-Ro52, anti-Ro60, anti-p200, and anti-La antibodies were assayed using home-made ELISA assays. Isolated antibody positivity was found in 25 women (15.3%), while multiple antibody positivity in 138 (84.7%). Twenty-four developed CHB, and the 139 had a favorable pregnancy outcome. The prevalence of isolated anti-Ro/SSA 60 kd antibodies was significantly higher (p < 0.046) as the prevalence of lower mean antibody titers (p < 0.0001) in the later group. Confirmation of these results by large-scale studies could lead clinicians to recommend less stringent fetal echocardiography monitoring in women with isolated anti-Ro/SSA 60 kd antibodies.
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Tonello
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Ariela
authors.initials: A
authors.lastname: Hoxha
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Mattia
authors.affiliation: Gynaecology and Obstetrics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zambon
authors.affiliation: Gynaecology and Obstetrics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Visentin
authors.affiliation: Paediatric Cardiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Cerutti
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Ghirardello
authors.affiliation: Paediatric Cardiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
authors.forename: Ornella
authors.initials: O
authors.lastname: Milanesi
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy. amelia.ruffatti@unipd.it.
authors.forename: Amelia
authors.initials: A
authors.lastname: Ruffatti
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000097:blood / Q000151:congenital* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C035356:SS-A antibodies
keywords: Anti-La/SSB; Anti-Ro/SSA 52kd; Anti-Ro/SSA 60 kd; Anti-p200; Congenital heart block; Isolated autoantibodies