{"title":"Predictive factors of fetal cardiac manifestations of neonatal lupus in anti-SSA and/or Ro-SSB/La antibody-positive pregnant women.","authors":"Jian Wu, Yanping Ruan, Hairui Wang, Xiaoyan Gu, Jiancheng Han, Yihua He","doi":"10.1055/a-2657-6178","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The factors associated with the development of cardiac manifestations of neonatal lupus (cardiac-NL) in fetuses with positive anti-SSA/Ro and/or SSB/La (anti-SSA/SSB) antibodies are unclear. This study aimed to investigate the predictive factors of fetal cardiac-NL in anti-SSA/SSB antibody-positive pregnant women.</p><p><strong>Study design: </strong>A total of 669 pregnant women with positive anti-SSA/SSB antibodies were retrospectively included. We determined whether the fetus had cardiac-NL and collected relevant clinical data. Univariate and multivariate analyses were performed to analyze the correlation between fetal cardiac-NL and clinical characteristics.</p><p><strong>Results: </strong>Among 669 pregnant women with positive anti-SSA/SSB antibody tests, 26 cases of fetal cardiac-NL occurred. Univariate analysis showed that fetal cardiac-NL was positively correlated with the assisted reproduction (OR 2.824, P = 0.045), strong positive anti-SSA/SSB antibody (OR 6.437, P < 0.001), and clinical diagnosis of connective tissue disease (CTD) (OR 4.701, P = 0.037); it was negatively correlated with the use of hydroxychloroquine (HCQ) (OR 0.187, P < 0.001) and aspirin (OR 0.369, P = 0.048). Multivariate analysis showed that the assisted reproduction (OR 4.110, P = 0.029), strong positive anti-SSA/SSB antibody (OR 8.691, P < 0.001), and clinical diagnosis of CTD (OR 8.614, P = 0.010) were risk factors for fetal cardiac-NL; while HCQ (OR 0.091, P < 0.001) and aspirin (OR 0.318, P = 0.035) were protective factors for fetal cardiac-NL.</p><p><strong>Conclusion: </strong>This study determined that assisted reproduction, strong positive anti-SSA/SSB antibody, and clinical diagnosis of CTD are independent risk factors for fetal cardiac-NL. The use of HCQ and aspirin are independent protective factors for fetal cardiac-NL.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2657-6178","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The factors associated with the development of cardiac manifestations of neonatal lupus (cardiac-NL) in fetuses with positive anti-SSA/Ro and/or SSB/La (anti-SSA/SSB) antibodies are unclear. This study aimed to investigate the predictive factors of fetal cardiac-NL in anti-SSA/SSB antibody-positive pregnant women.
Study design: A total of 669 pregnant women with positive anti-SSA/SSB antibodies were retrospectively included. We determined whether the fetus had cardiac-NL and collected relevant clinical data. Univariate and multivariate analyses were performed to analyze the correlation between fetal cardiac-NL and clinical characteristics.
Results: Among 669 pregnant women with positive anti-SSA/SSB antibody tests, 26 cases of fetal cardiac-NL occurred. Univariate analysis showed that fetal cardiac-NL was positively correlated with the assisted reproduction (OR 2.824, P = 0.045), strong positive anti-SSA/SSB antibody (OR 6.437, P < 0.001), and clinical diagnosis of connective tissue disease (CTD) (OR 4.701, P = 0.037); it was negatively correlated with the use of hydroxychloroquine (HCQ) (OR 0.187, P < 0.001) and aspirin (OR 0.369, P = 0.048). Multivariate analysis showed that the assisted reproduction (OR 4.110, P = 0.029), strong positive anti-SSA/SSB antibody (OR 8.691, P < 0.001), and clinical diagnosis of CTD (OR 8.614, P = 0.010) were risk factors for fetal cardiac-NL; while HCQ (OR 0.091, P < 0.001) and aspirin (OR 0.318, P = 0.035) were protective factors for fetal cardiac-NL.
Conclusion: This study determined that assisted reproduction, strong positive anti-SSA/SSB antibody, and clinical diagnosis of CTD are independent risk factors for fetal cardiac-NL. The use of HCQ and aspirin are independent protective factors for fetal cardiac-NL.
期刊介绍:
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.