Maternal and fetal outcome in neonatal lupus erythematosus.

Maternal health, children's health, and obstetric histories were assessed in a follow-up study of 21 families with children with neonatal lupus erythematosus; this group constituted approximately 15% of all reported cases. Twenty-one mothers had twenty-four children with the disease. Twelve children had congenital heart block (5 boys, 7 girls), 10 had cutaneous lupus lesions (1 boy, 9 girls), and 2 girls had both heart block and cutaneous lesions. Although half of the mothers were initially asymptomatic, 18 of 21 have developed symptoms during the follow-up period (range, 0.25 to 9.5 years). Three of the children died in the neonatal period. The 21 children who survived have been asymptomatic during follow-up, although 5 of 11 with heart block have pacemakers. The mothers did not have an increased risk for spontaneous abortions. Three of twelve livebirths after the birth of the first child with neonatal lupus erythematosus resulted in another affected child.