Wu Jian, Ruan Yanping, Wang Hairui, Gu Xiaoyan, Han Jiancheng, He Yihua
Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Am J Perinatol. 2025 Jul 30. doi: 10.1055/a-2657-6178.
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.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.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 (odds ratio [OR]: 2.824; = 0.045), strong positive anti-SSA/SSB antibody (OR: 6.437; < 0.001), and clinical diagnosis of connective tissue disease (CTD; OR: 4.701; = 0.037); it was negatively correlated with the use of hydroxychloroquine (HCQ; OR: 0.187; < 0.001) and aspirin (OR: 0.369; = 0.048). Multivariate analysis showed that the assisted reproduction (OR: 4.110; = 0.029), strong positive anti-SSA/SSB antibody (OR: 8.691; < 0.001), and clinical diagnosis of CTD (OR: 8.614; = 0.010) were risk factors for fetal cardiac-NL; while HCQ (OR: 0.091; < 0.001) and aspirin (OR: 0.318; = 0.035) were protective factors for fetal cardiac-NL.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 factor for fetal cardiac-NL. · Anti-SSA/SSB antibodies can lead to fetal cardiac-NL.. · Assisted reproduction, strong positive anti-SSA/SSB antibodies, and CTD are risk factors.. · HCQ and aspirin use may lower the risk of fetal cardiac-NL..
抗SSA/Ro和/或SSB/La（抗SSA/SSB）抗体呈阳性的胎儿发生新生儿狼疮心脏表现（心脏型新生儿狼疮）的相关因素尚不清楚。本研究旨在调查抗SSA/SSB抗体阳性孕妇中胎儿心脏型新生儿狼疮的预测因素。
共纳入669例抗SSA/SSB抗体阳性的孕妇，进行回顾性研究。我们确定胎儿是否患有心脏型新生儿狼疮，并收集相关临床资料。采用单因素和多因素分析来分析胎儿心脏型新生儿狼疮与临床特征之间的相关性。
在669例抗SSA/SSB抗体检测呈阳性的孕妇中，有26例胎儿发生心脏型新生儿狼疮。单因素分析显示，胎儿心脏型新生儿狼疮与辅助生殖（比值比[OR]：2.824；P = 0.045）、抗SSA/SSB抗体强阳性（OR：6.437；P < 0.001）以及结缔组织病（CTD）临床诊断（OR：4.701；P = 0.037）呈正相关；与使用羟氯喹（HCQ；OR：0.187；P < 0.001）和阿司匹林（OR：0.369；P = 0.048）呈负相关。多因素分析显示，辅助生殖（OR：4.110；P = 0.029）、抗SSA/SSB抗体强阳性（OR：8.691；P < 0.001）以及CTD临床诊断（OR：8.614；P = 0.010）是胎儿心脏型新生儿狼疮的危险因素；而HCQ（OR：0.091；P < 0.001）和阿司匹林（OR：0.318；P = 0.035）是胎儿心脏型新生儿狼疮的保护因素。
本研究确定，辅助生殖、抗SSA/SSB抗体强阳性以及CTD临床诊断是胎儿心脏型新生儿狼疮的独立危险因素。使用HCQ和阿司匹林是胎儿心脏型新生儿狼疮的独立保护因素。·抗SSA/SSB抗体可导致胎儿心脏型新生儿狼疮。·辅助生殖、抗SSA/SSB抗体强阳性以及CTD是危险因素。·使用HCQ和阿司匹林可能降低胎儿心脏型新生儿狼疮的风险。
