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Pregnancy outcome in 100 women with autoimmune diseases and anti-Ro/SSA antibodies: a prospective controlled study

Ospedale Niguarda, Milano, Italy; Via del Bollo 4, 20123 Milano, Italy abrucato{at}ospedale-niguarda.it

A Doria

University of Padova, Padova, Italy

M Frassi

Spedali Civili, Brescia, Italy

G Castellino

Ospedale Niguarda, Milano, Italy

F Franceschini

D Faden

Spedali Civili, Brescia, Italy

M Pia Pisoni

L Solerte

M Muscarà

Ospedale Niguarda, Milano, Italy

A Lojacono

M Motta

I Cavazzana

Spedali Civili, Brescia, Italy

A Ghirardello

F Vescovi

University of Padova, Padova, Italy

V Tombini

Ospedale Niguarda, Milano, Italy

R Cimaz

Istituti Clinici di Perfezionamento, Milano, Italy

P F Gambari

University of Padova, Padova, Italy

P L Meroni

Department of Internal Medicine, University of Milan, Allergy and Clinical Immunology Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy

B Canesi

Ospedale Niguarda, Milano, Italy

A Tincani

Spedali Civili, Brescia, Italy

Anti-Ro/SSA antibodies are associated with neonatal lupus but are also considered a possible cause for unexplainedpregnancy loss and adverse pregnancy outcome. In a large multicentres cohort study we have prospectivelyfollowed 100 anti-Ro/SSA positivewomen (53 systemic lupus erythematosus (SLE)) during their 122 pregnancies and 107 anti-Ro/SSA negative women (58 SLE) (140 pregnancies).Anti-Ro/SSA antibodies were tested by immunoblot and counterimmunoelectrophoresis. Mean gestational age at delivery (38 vs 37.9 weeks), prevalence of pregnancy loss (9.9 vs 18.6%), preterm birth (21.3 vs 13.9%), cesarean sections (49.2 vs 53.4%), premature rupture of membranes(4.9 vs 8.1%), preeclampsia(6.6 vs 8.1%), intrauterinegrowth retardation(0 vs 2.3%) and newborns small for gestationalage (11.5 vs 5.8%) were similar in anti-Ro/SSA positive and negative SLE mothers; findings were similar in non-SLE women. Two cases of congenital heart block were observed out of 100 anti-Ro/SSA positive women. In conclusion, anti-Ro/SSA antibodies are responsiblefor congenitalheart block but do not affect other pregnancyoutcomes,both in SLE and in non-SLE women. The general outcome of these pregnancies is now very good, if prospectively followedby multidisciplinaryteams with ample experiencein this field.

Key Words: anti-Ro/SSA antibodies • congenital heart block • pregnancy • primary Sjogren's syndrome • systemic lupus erythematosus

Lupus, Vol. 11, No. 11, 716-721 (2002)
DOI: 10.1191/0961203302lu252oa


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