Maternal and Fetal Factors Associated With Mortality and Morbidity in a Multi-Racial/Ethnic Registry of Anti-SSA/Ro-Associated Cardiac Neonatal Lupus

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dc.contributor.authorIzmirly, Peter M.
dc.contributor.authorSaxena, Amit
dc.contributor.authorKim, Mimi Y.
dc.contributor.authorWang, Dan
dc.contributor.authorSahl, Sara K.
dc.contributor.authorLlanos, Carolina
dc.contributor.authorFriedman, Deborah
dc.contributor.authorBuyon, Jill P.
dc.date.accessioned2024-01-10T13:14:39Z
dc.date.available2024-01-10T13:14:39Z
dc.date.issued2011
dc.description.abstractBackground-Cardiac manifestations of neonatal lupus include conduction disease and, rarely, an isolated cardiomyopathy. This study was initiated to determine the mortality and morbidity of cardiac neonatal lupus and associated risk factors in a multi-racial/ethnic US-based registry to provide insights into the pathogenesis of antibody-mediated injury and data for counseling.
dc.description.abstractMethods and Results-Three hundred twenty-five offspring exposed to maternal anti-SSA/Ro antibodies with cardiac neonatal lupus met entry criteria. Maternal, fetal echocardiographic, and neonatal risk factors were assessed for association with mortality. Fifty-seven (17.5%) died, 30% in utero. The probability of in utero death was 6%. The cumulative probability of survival at 10 years for a child born alive was 86%. Fetal echocardiographic risk factors associated with increased mortality in a multivariable analysis of all cases included hydrops and endocardial fibroelastosis. Significant predictors of in utero death were hydrops and earlier diagnosis, and of postnatal death were hydrops, endocardial fibroelastosis, and lower ventricular rate. Isolated heart block was associated with a 7.8% case fatality rate, whereas the concomitant presence of dilated cardiomyopathy or endocardial fibroelastosis quadrupled the case fatality rate. There was a significantly higher case fatality rate in minorities compared with whites, who were at a lower risk of hydrops and endocardial fibroelastosis. Pacing was required in 70%; cardiac transplantation was required in 4 children.
dc.description.abstractConclusion-Nearly one fifth of fetuses who develop cardiac neonatal lupus die of complications predicted by echocardiographic abnormalities consistent with antibody-associated disease beyond the atrioventricular node. The disparity in outcomes observed between minorities and whites warrants further investigation. (Circulation. 2011; 124: 1927-1935.)
dc.description.funderNational Institute of Arthritis and Musculoskeletal and Skin Disease
dc.description.funderAmerican Heart Association
dc.description.funderPfizer
dc.description.funderNATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
dc.fechaingreso.objetodigital2024-05-20
dc.format.extent9 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1161/CIRCULATIONAHA.111.033894
dc.identifier.eissn1524-4539
dc.identifier.issn0009-7322
dc.identifier.pubmedidMEDLINE:21969015
dc.identifier.urihttps://doi.org/10.1161/CIRCULATIONAHA.111.033894
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/78428
dc.identifier.wosidWOS:000296593800015
dc.information.autorucMedicina;Llanos C ;S/I;1007976
dc.issue.numero18
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final1935
dc.pagina.inicio1927
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.revistaCIRCULATION
dc.rightsacceso restringido
dc.subjectantibodies
dc.subjectcardiomyopathy
dc.subjectheart block
dc.subjectmorbidity
dc.subjectmortality
dc.subjectCONGENITAL HEART-BLOCK
dc.subjectCOMPLETE ATRIOVENTRICULAR-BLOCK
dc.subjectCONNECTIVE-TISSUE DISEASE
dc.subjectENDOCARDIAL FIBROELASTOSIS
dc.subjectRECURRENCE RATES
dc.subjectLA ANTIBODIES
dc.subjectMOTHERS
dc.subjectCHILDREN
dc.subjectRISK
dc.subjectRO
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleMaternal and Fetal Factors Associated With Mortality and Morbidity in a Multi-Racial/Ethnic Registry of Anti-SSA/Ro-Associated Cardiac Neonatal Lupus
dc.typeartículo
dc.volumen124
sipa.codpersvinculados1007976
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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