A case-control study of congenital heart block: association with maternal antibodies to Ro(SS-A) and La(SS-B)
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M McCredie1, J Celermajer, G Sholler
1Sydney University Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia.
Insights
Maternal autoantibodies, specifically anti-Ro(SS-A) and anti-La(SS-B), significantly increase the risk of congenital complete heart block (CHB) in infants. This study confirms the association in an Australian population.
Area of Science:
- Immunology
- Cardiology
- Obstetrics
Background:
- Congenital complete heart block (CHB) is a serious condition affecting newborns.
- Maternal connective tissue diseases and autoantibodies are suspected risk factors for CHB.
- Previous research has indicated a link between anti-Ro(SS-A) antibodies and CHB.
Purpose of the Study:
- To investigate the association between maternal autoantibodies, particularly anti-Ro(SS-A) and anti-La(SS-B), and the occurrence of CHB.
- To determine the risk factors for CHB in an Australian population.
Main Methods:
- A case-control study was conducted with 18 cases of CHB and 72 controls.
- Mothers completed questionnaires and provided blood samples for autoantibody testing.
- Statistical analysis was used to assess the odds of CHB in relation to maternal antibodies.
Main Results:
- Women with antibodies to Ro(SS-A) and/or La(SS-B) had a 22-fold increased odds of giving birth to a child with CHB.
- The association was significant, confirming the role of these autoantibodies.
Conclusions:
- Maternal anti-Ro(SS-A) and anti-La(SS-B) antibodies are significant risk factors for CHB.
- These findings highlight the importance of screening for autoantibodies in at-risk pregnancies.
- Further research may elucidate the precise mechanisms linking these antibodies to cardiac development.
Abstract:
A case control study of congenital complete heart block (CHB) was undertaken to determine the degree of association of this condition with maternal connective tissue disease and with maternal autoantibodies, in particular those to Ro(SS-A). Mothers of cases (n = 18) and controls (n = 72) completed a self-administered questionnaire and donated 10 ml of blood. The odds of giving birth to a child with CHB were increased by a factor of 22 for women with antibodies to Ro(SS-A) and/or La(SS-B) compared with women who did not have these antibodies. Thus the association between CHB and both anti-Ro(SS-A) and anti-La(SS-B) antibodies has been demonstrated in an Australian population and indicates that anti-La(SS-B), as well as anti-Ro(SS-A) antibodies may be a risk factor for the development of CHB.