[Neonatal lupus syndrome: Literature review]

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Immunology

Context:

• Neonatal lupus syndrome (NLS) arises from maternal autoantibodies crossing the placenta.
• Key antibodies involved are anti-SSA/Ro and anti-SSB/La.
• Affected infants present with diverse symptoms, including cardiac, cutaneous, hematological, and hepatic manifestations.

Purpose:

• To summarize the clinical features, prevalence, and management of neonatal lupus syndrome, with a focus on cardiac manifestations.
• To highlight the importance of maternal antibody screening and fetal monitoring in at-risk pregnancies.
• To review current and emerging therapeutic strategies for NLS.

Summary:

• Congenital heart block (CHB) is a significant cardiac complication of NLS, occurring in 1-2% of newborns from mothers with connective tissue disease and anti-Ro/SSA antibodies.
• While skin and systemic lesions are typically transient, CHB is permanent, leading to high morbidity (18% mortality, 2/3 requiring pacemakers).
• Maternal hydroxychloroquine use may reduce recurrent CHB risk, and ongoing research is evaluating its efficacy.

Impact:

• Emphasizes the need for vigilant prenatal screening and monitoring in pregnancies involving anti-SSA/Ro positive mothers.
• Informs clinical practice regarding the management of NLS and its cardiac complications.
• Highlights potential preventative strategies like maternal hydroxychloroquine use and the need for further research.