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Congenital heart block and maternal systemic lupus erythematosus
Insights
Maternal connective-tissue disease (CTD) is linked to congenital heart block (CHB) in infants. Approximately one-third of mothers with CHB-affected babies have or will develop CTD, likely due to antibody transfer.
Area of Science:
- Cardiology
- Immunology
- Obstetrics
Background:
- Congenital heart block (CHB) is a serious condition in newborns.
- Maternal autoimmune diseases, such as systemic lupus erythematosus, are suspected risk factors.
- The specific association between CHB and maternal connective-tissue disease (CTD) requires further elucidation.
Purpose of the Study:
- To investigate the association between CHB in infants and maternal CTD.
- To determine the prevalence of maternal CTD in cases of infant CHB.
- To explore potential mechanisms and implications for prevention and neonatal care.
Main Methods:
- A review of 67 cases involving infants with CHB.
- Analysis of maternal medical history for CTD diagnosis (current or future).
- Examination of necropsy findings in affected infants.
Main Results:
- CHB was diagnosed at or before birth in 24 of the 67 cases.
- Endomyocardial fibrosis was observed in seven out of nine infant necropsies.
- The study suggests that one in three mothers of infants with CHB have or will develop CTD.
Conclusions:
- A significant association exists between infant CHB and maternal CTD.
- Maternal antibodies transferred across the placenta are the likely cause.
- Increased awareness can aid in preventing CHB births and improving neonatal care.
Abstract:
The association between infants with congenital heart block (CHB) and the presence or later development of maternal systemic lupus erythematosus or other connective-tissue disease (CTD) was reviewed in 67 cases. In 24 cases CHB was diagnosed at or before birth. Of nine necropsies on affected infants, seven showed endomyocardial fibrosis. The results suggest that one in three mothers who deliver babies with CHB have or will develop CTD. The association is probably explained by placental transfer of a maternal antibody. Awareness of the association may lead to prevention of the birth of children with CHB and better neonatal care of affected children.