Korean J Pediatr.  2006 Apr;49(4):381-387. 10.3345/kjp.2006.49.4.381.

Outcome of pregnant mothers with systemic lupus erythematosus (focusing on congenital heart block)

• Baek HS
• Choi JH
• Kim NS
• Kim CR
• Moon SJ

• KMID: 2140903
• DOI: http://doi.org/10.3345/kjp.2006.49.4.381

Abstract

PURPOSE: Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE.
METHODS
The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record.
RESULTS
There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018).
CONCLUSION
The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

Keyword

SLE; Neonatal lupus; Congenital complete heart block; Anti-SSA/Ro; Anti-SSB/La antibodies

MeSH Terms

Abortion, Spontaneous
Antibodies, Anticardiolipin
Antibodies, Antiphospholipid
Diagnosis
Electrocardiography
Exanthema
Female
Fetus
Gestational Age
Heart*
Humans
Incidence
Infant
Infant, Newborn
Live Birth
Lupus Erythematosus, Systemic*
Medical Records
Mothers*
Neutropenia
Parturition
Pregnancy
Retrospective Studies
Skin
Thrombocytopenia
Antibodies, Anticardiolipin
Antibodies, Antiphospholipid