Anti-Ro antibodies and neonatal lupus

The presence of antibodies directed against the Ro (SS-A) antigen is the strongest risk factor for the neonatal lupus syndrome. In most instances, the pregnant woman is asymptomatic; however, the presence of subclinical connective tissue disease and the subsequent emergence of overt connective tissue disease have been reported. This article will review the molecular biology of the Ro antigen, assays for anti-Ro antibodies, prevalence of anti-Ro antibody in normal people and patients with systemic lupus erythematosus, and the clinical, immunogenetic and pathophysiologic features of the neonatal lupus syndrome. Finally, current concepts concerning treatment of pregnant women with anti-Ro antibodies will be reviewed.