Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
Am J Obstet Gynecol. 2013 Jan;208(1):64.e1-7. doi: 10.1016/j.ajog.2012.09.020. Epub 2012 Sep 28.
The importance of maternal autoantibody levels in congenital heart block and elucidation of maternal factors that may reduce disease burden require further clarification.
Pregnancies complicated by maternal anti-Ro antibodies from 2007 through 2011 were retrospectively reviewed.
In all, 33 women were followed up throughout pregnancy. Semiquantitative maternal anti-La levels were significantly higher in pregnancies complicated by fetal heart block of any degree (median difference, 227.5; P = .04), but there was no difference in maternal anti-Ro levels. In all, 94% of fetuses maintained normal conduction when the mother was treated with hydroxychloroquine or daily prednisone therapy throughout pregnancy, compared to 59% in the untreated group (odds ratio, 0.1; P = .04).
Pregnancies complicated by fetal heart block did not have higher levels of maternal anti-Ro antibodies. Maternal anti-La level may be a useful predictor of fetal heart block. Maternal treatment with either hydroxychloroquine or daily low-dose prednisone throughout pregnancy may provide a protective effect.
母体自身抗体水平在先天性心脏传导阻滞中的重要性，以及阐明可能降低疾病负担的母体因素，这些都需要进一步阐明。
回顾性分析了 2007 年至 2011 年间因母体抗 Ro 抗体而复杂化的妊娠。
共有 33 名妇女在整个孕期得到了随访。在任何程度的胎儿心脏传导阻滞的妊娠中，母体抗 La 水平的半定量水平明显更高（中位数差异为 227.5；P =.04），但母体抗 Ro 水平没有差异。在整个孕期接受羟氯喹或每日泼尼松治疗的母亲中，94%的胎儿保持正常传导，而未接受治疗的母亲中，这一比例为 59%（比值比，0.1；P =.04）。
胎儿心脏传导阻滞的妊娠并没有更高水平的母体抗 Ro 抗体。母体抗 La 水平可能是胎儿心脏传导阻滞的一个有用的预测指标。在整个孕期内使用羟氯喹或每日低剂量泼尼松治疗母亲可能提供保护作用。
