Sjogren's Antibodies and Neonatal Lupus: A Scoping Review

Area of Science:

• Rheumatology
• Immunology
• Maternal-Fetal Medicine

Background:

• Sjogren's syndrome (SS) is an autoimmune disorder causing exocrine gland inflammation, primarily affecting middle-aged women.
• Maternal autoantibodies, specifically anti-SS-A/Ro and anti-SS-B/La, are implicated in fetal complications.
• These antibodies can cross the placenta, potentially causing neonatal lupus and congenital heart block (CHB).

Purpose of the Study:

• To review the literature on pregnancy outcomes in women with Sjogren's syndrome.
• To examine the clinical manifestations and pathogenesis of neonatal lupus and CHB.
• To assess current and future management strategies for pregnant women with SS.

Main Methods:

• A scoping review of literature published between 2001 and 2024.
• Analysis focused on pregnancy outcomes, neonatal lupus, CHB, and the role of specific autoantibodies.
• Literature search included studies on diagnostic and therapeutic interventions.

Main Results:

• Maternal anti-SS-A/Ro and anti-SS-B/La antibodies are strongly associated with neonatal lupus and CHB.
• Echocardiography and home fetal heart rate monitoring are recommended for early CHB detection.
• Hydroxychloroquine and glucocorticoids show potential in mitigating cardiac manifestations, but require further investigation.

Conclusions:

• Pregnant women with Sjogren's syndrome require vigilant fetal monitoring for CHB.
• Further research is essential to optimize treatment protocols and improve clinical care for this population.
• Understanding the role of autoantibodies is key to preventing adverse neonatal outcomes.