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

Korean Journal of Pediatrics 2006;49(4):381-387.
Published online April 15, 2006.
Outcome of pregnant mothers with systemic lupus erythematosus(focusing on congenital heart block)
Hey Sung Baek, Jae Hyung Choi, Nam Su Kim, Chang Ryul Kim, Su Ji Moon
Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
전신성 홍반성 루푸스 산모의 출산아의 임상적 고찰(완전 방실 블록을 중심으로)
백혜성, 최재형, 김남수, 김창렬, 문수지
한양대학교 의과대학 소아과학교실
Correspondence: 
Su Ji Moon, Email: moonsoojee@hangyang.ac.kr
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.
Key Words: SLE , Neonatal lupus , Congenital complete heart block , Anti-SSA/Ro , Anti-SSB/La antibodies


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