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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
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Factors associated with long-term cardiac dysfunction in neonatal lupus
Amit Saxena1, Peter M Izmirly2, Rebecca P Bomar2
1Medicine, NYU School of Medicine, New York, New York, United States amit.saxena@nyulangone.org.
Annals of the Rheumatic Diseases
|November 2, 2019
Summary
Cardiac dysfunction in neonatal lupus (NL) can persist into adulthood, though it often normalizes in childhood. Risk factors identified in fetal life influence long-term cardiac health in affected individuals.
Area of Science:
- Cardiology
- Pediatrics
- Rheumatology
Background:
- Neonatal lupus (NL) cardiac manifestations are linked to significant morbidity and mortality.
- Long-term outcomes for individuals with cardiac NL require further investigation.
Purpose of the Study:
- To assess cardiac dysfunction in neonatal lupus across multiple age groups.
- To identify risk factors for cardiac dysfunction in NL.
- To inform counseling, understand pathogenesis, and develop preventative strategies.
Main Methods:
- Echocardiogram reports of 239 individuals with cardiac NL were analyzed.
- Data was stratified into age groups: 0-1 year, >1-17 years, and >17 years.
- Logistic regression and imputation were used to identify risk factors for cardiac dysfunction.
Main Results:
- Cardiac dysfunction prevalence was 22.4% (0-1 yr), 14.8% (>1-17 yrs), and 28.1% (>17 yrs).
- Risk factors included male sex, black race, lower fetal heart rates, fetal extranodal cardiac disease, and pacing duration.
- While some early dysfunction resolved, new-onset dysfunction occurred in childhood and adulthood.
Conclusions:
- Fetal risk factors significantly impact cardiac morbidity into adulthood for neonatal lupus patients.
- Cardiac dysfunction in infancy often resolves by later childhood.
- New-onset cardiac dysfunction can emerge after infancy in individuals with neonatal lupus.
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