Maternal predictive factors for fetal congenital heart block in pregnant mothers positive for anti-SS-A antibodies

被引：15

作者：

Tsuboi, Hiroto ^{[1
,14
]}

Sumida, Takayuki ^{[1
,14
]}

Noma, Hisashi ^{[2
,14
]}

Yamagishi, Kazumasa ^{[3
,14
]}

Anami, Ai ^{[4
,14
]}

Fukushima, Kotaro ^{[4
,14
]}

Horigome, Hitoshi ^{[5
,14
]}

Maeno, Yasuki ^{[6
,14
]}

Kishimoto, Mitsumasa ^{[7
,14
]}

Takasaki, Yoshinari ^{[8
,14
]}

Nakayama, Masahiro ^{[9
,10
,14
]}

Waguri, Masako ^{[10
,11
,14
]}

Sago, Haruhiko ^{[12
,14
]}

Murashima, Atsuko ^{[13
,14
]}

机构：

[1] Univ Tsukuba, Dept Internal Med, Fac Med, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan

[2] Inst Stat Math, Dept Data Sci, Tokyo, Japan

[3] Univ Tsukuba, Dept Publ Hlth Med, Fac Med, Tsukuba, Ibaraki 3058575, Japan

[4] Kyushu Univ Hosp, Dept Obstet & Gynecol, Fukuoka 812, Japan

[5] Univ Tsukuba, Dept Child Hlth, Fac Med, Tsukuba, Ibaraki 3058575, Japan

[6] Kurume Univ, Sch Med, Dept Pediat & Child Hlth, Fukuoka, Japan

[7] St Lukes Int Hosp, Immunorheumatol Ctr, Tokyo, Japan

[8] Juntendo Univ, Sch Med, Dept Rheumatol, Tokyo 113, Japan

[9] Osaka Med Ctr, Dept Lab Med, Osaka, Japan

[10] Res Inst Maternal & Child Hlth, Osaka, Japan

[11] Osaka Med Ctr, Dept Maternal Med, Osaka, Japan

[12] Natl Ctr Child Hlth & Dev, Ctr Maternal Fetal Neonatal & Reprod Med, Tokyo, Japan

[13] Natl Ctr Child Hlth & Dev, Dept Maternal Med, Tokyo, Japan

[14] Japan Minist Hlth Labor & Welf MHLW H22 Jisedai I, Res Program, Res Team Surveillance Autoantibody Exposed Fetuse, Tokyo, Japan

来源：

MODERN RHEUMATOLOGY | 2016年 / 26卷 / 04期

关键词：

Anti-SS-A antibodies; Congenital heart block; Risk factor; NEONATAL LUPUS; RISK; MANIFESTATIONS; REGISTRY; CHILDREN; SSA/RO; WOMEN;

D O I：

10.3109/14397595.2015.1106661

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To determine the maternal predictive factors for fetal congenital heart block (CHB) in pregnancy in mothers positive for anti-SS-A antibodies.Methods: The Research Team for Surveillance of Autoantibody-Exposed Fetuses and Treatment of Neonatal Lupus Erythematosus, the Research Program of the Japan Ministry of Health, Labor and Welfare, performed a national survey on pregnancy of mothers positive for anti-SS-A antibodies. We analyzed 635 pregnant mothers who tested positive for anti-SS-A antibodies before conception but had no previous history of fetal CHB. We performed univariate and multivariate analysis (models 1, 2, and 3 using different set of independent variables) investigated the relation between risk of fetal CHB and maternal clinical features.Results: Of the 635 pregnant mothers, fetal CHB was detected in 16. Univariate analysis showed that fetal CHB associated with use of corticosteroids before conception (OR 3.72, p=0.04), and negatively with use of corticosteroids (equivalent doses of prednisolone (PSL), at10mg/day) after conception before 16-week gestation (OR 0.17, p=0.03). In multivariate analysis, model 1 identified the use of corticosteroids before conception (OR 4.28, p=0.04) and high titer of anti-SS-A antibodies (OR 3.58, p=0.02) as independent and significant risk factors, and model 3 identified use of corticosteroids (equivalent doses of PSL, at10mg/day) after conception before 16-week gestation as independent protective factor against the development of fetal CHB (OR 0.16, p=0.03). Other maternal clinical features did not influence the development of fetal CHB.Conclusion: The results identified high titers of anti-SS-A antibodies and use of corticosteroids before conception as independent risk factors, and use of corticosteroids (equivalent doses of PSL, at10mg/day) after conception before 16-week gestation as an independent protective factor for fetal CHB.

引用

页码：569 / 575

页数：7

共 16 条

[1] Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern [J].