{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:45:36Z","timestamp":1789076736204,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01\u2010HD\u2010100929"],"award-info":[{"award-number":["R01\u2010HD\u2010100929"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["N01\u2010AR\u2010042220"],"award-info":[{"award-number":["N01\u2010AR\u2010042220"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P50\u2010AR\u2010070591"],"award-info":[{"award-number":["P50\u2010AR\u2010070591"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This prospective study of pregnant patients, <jats:bold>S<\/jats:bold>urveillance <jats:bold>To P<\/jats:bold>revent AV <jats:bold>B<\/jats:bold>lock <jats:bold>L<\/jats:bold>ikely to <jats:bold>O<\/jats:bold>ccur <jats:bold>Q<\/jats:bold>uickly (STOP BLOQ), addresses the impact of anti\u2010SSA\/Ro titers and utility of ambulatory monitoring in the detection of fetal second\u2010degree atrioventricular block (AVB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with anti\u2010SSA\/Ro autoantibodies by commercial testing were stratified into high and low anti\u201352\u2010kD and\/or 60\u2010kD SSA\/Ro titers applying at\u2010risk thresholds defined by previous evaluation of AVB pregnancies. The high\u2010titer group performed fetal heart rate and rhythm monitoring (FHRM) thrice daily and weekly\/biweekly echocardiography from 17\u201326\u2009weeks. Abnormal FHRM prompted urgent echocardiography to identify AVB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Anti\u201352\u2010kD and\/or 60\u2010kD SSA\/Ro met thresholds for monitoring in 261 of 413 participants (63%); for those, AVB frequency was 3.8%. No cases occurred with low titers. The incidence of AVB increased with higher levels, reaching 7.7% for those in the top quartile for anti\u201360\u2010kD SSA\/Ro, which increased to 27.3% in those with a previous child who had AVB. Based on levels from 15 participants with paired samples from both an AVB and a non\u2010AVB pregnancy, healthy pregnancies were not explained by decreased titers. FHRM was considered abnormal in 45 of 30,920 recordings, 10 confirmed AVB by urgent echocardiogram, 7 being second\u2010degree AVB, all &lt;12 hours from normal FHRM and within another 0.75 to 4 hours to echocardiogram. The one participant with second\/third\u2010degree and two participants with third\u2010degree AVB were diagnosed by urgent echocardiogram &gt;17 to 72 hours from an FHRM. Surveillance echocardiograms detected no AVB when the preceding interval FHRM recordings were normal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High\u2010titer antibodies are associated with an increased incidence of AVB. Anti\u2010SSA\/Ro titers remain stable over time and do not explain the discordant recurrence rates, suggesting that other factors are required. Fetal heart rate and rhythm (FHRM) with results confirmed by a pediatric cardiologist reliably detects conduction abnormalities, which may reduce the need for serial echocardiograms.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art42733-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42733","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T08:09:00Z","timestamp":1699603740000},"page":"411-420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Prospective Evaluation of High Titer Autoantibodies and Fetal Home Monitoring in the Detection of Atrioventricular Block Among Anti\u2010SSA\/Ro Pregnancies"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3852-7129","authenticated-orcid":false,"given":"Jill. 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