{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:52:03Z","timestamp":1781535123549,"version":"3.54.5"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"name":"Beijing Natural Science Foundation","award":["7234360"],"award-info":[{"award-number":["7234360"]}]},{"name":"Beijing Key Laboratory of Maternal\u2013Fetal Medicine in Fetal Heart Disease","award":["BZ0308"],"award-info":[{"award-number":["BZ0308"]}]},{"name":"Beijing Municipal Commission of Science and Technology","award":["Z231100007423010"],"award-info":[{"award-number":["Z231100007423010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The factors associated with the development of cardiac manifestations of neonatal lupus (cardiac-NL) in fetuses with positive anti-SSA\/Ro and\/or SSB\/La (anti-SSA\/SSB) antibodies are unclear. This study aimed to investigate the predictive factors of fetal cardiac-NL in anti-SSA\/SSB antibody-positive pregnant women.<\/jats:p>\n                  <jats:p>A total of 669 pregnant women with positive anti-SSA\/SSB antibodies were retrospectively included. We determined whether the fetus had cardiac-NL and collected relevant clinical data. Univariate and multivariate analyses were performed to analyze the correlation between fetal cardiac-NL and clinical characteristics.<\/jats:p>\n                  <jats:p>Among 669 pregnant women with positive anti-SSA\/SSB antibody tests, 26 cases of fetal cardiac-NL occurred. Univariate analysis showed that fetal cardiac-NL was positively correlated with the assisted reproduction (odds ratio [OR]: 2.824; p\u2009=\u20090.045), strong positive anti-SSA\/SSB antibody (OR: 6.437; p\u2009&lt;\u20090.001), and clinical diagnosis of connective tissue disease (CTD; OR: 4.701; p\u2009=\u20090.037); it was negatively correlated with the use of hydroxychloroquine (HCQ; OR: 0.187; p\u2009&lt;\u20090.001) and aspirin (OR: 0.369; p\u2009=\u20090.048). Multivariate analysis showed that the assisted reproduction (OR: 4.110; p\u2009=\u20090.029), strong positive anti-SSA\/SSB antibody (OR: 8.691; p\u2009&lt;\u20090.001), and clinical diagnosis of CTD (OR: 8.614; p\u2009=\u20090.010) were risk factors for fetal cardiac-NL; while HCQ (OR: 0.091; p\u2009&lt;\u20090.001) and aspirin (OR: 0.318; p\u2009=\u20090.035) were protective factors for fetal cardiac-NL.<\/jats:p>\n                  <jats:p>This study determined that assisted reproduction, strong positive anti-SSA\/SSB antibody, and clinical diagnosis of CTD are independent risk factors for fetal cardiac-NL. The use of HCQ and aspirin are independent protective factor for fetal cardiac-NL.<\/jats:p>","DOI":"10.1055\/a-2657-6178","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T23:58:02Z","timestamp":1752796682000},"page":"571-578","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Factors of Fetal Cardiac Manifestations of Neonatal Lupus in Anti-SSA\/Ro and\/or SSB\/La Antibody-Positive Pregnant Women"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-6155","authenticated-orcid":false,"given":"Jian","family":"Wu","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Ruan","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hairui","family":"Wang","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Gu","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiancheng","family":"Han","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihua","family":"He","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12016-009-8190-6","article-title":"Pregnancy outcomes in patients with autoimmune diseases and anti-Ro\/SSA antibodies","volume":"40","author":"A Brucato","year":"2011","journal-title":"Clin Rev Allergy Immunol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.hrthm.2012.12.030","article-title":"Pathophysiology, clinical course, and management of congenital complete atrioventricular block","volume":"10","author":"P Bordachar","year":"2013","journal-title":"Heart Rhythm"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1002\/1529-0131(200108)44:8<1832::AID-ART320>3.0.CO;2-C","article-title":"Risk of congenital complete heart block in newborns of mothers with anti-Ro\/SSA antibodies detected by counterimmunoelectrophoresis: a prospective study of 100 women","volume":"44","author":"A Brucato","year":"2001","journal-title":"Arthritis Rheum"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1067\/mpd.2003.233","article-title":"Incidence and spectrum of neonatal lupus erythematosus: a prospective study of infants born to mothers with anti-Ro autoantibodies","volume":"142","author":"R Cimaz","year":"2003","journal-title":"J Pediatr"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1161\/CIRCULATIONAHA.107.707661","article-title":"Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR interval and dexamethasone evaluation (PRIDE) prospective study","volume":"117","author":"D M Friedman","year":"2008","journal-title":"Circulation"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1097\/BOR.0b013e32832ed817","article-title":"Prevention of complete heart block in children of mothers with anti-SSA\/Ro and anti-SSB\/La autoantibodies: detection and treatment of first-degree atrioventricular block","volume":"21","author":"D Mevorach","year":"2009","journal-title":"Curr Opin Rheumatol"},{"issue":"18","key":"ref7","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1161\/CIRCULATIONAHA.111.033894","article-title":"Maternal and fetal factors associated with mortality and morbidity in a multi-racial\/ethnic registry of anti-SSA\/Ro-associated cardiac neonatal lupus","volume":"124","author":"P M Izmirly","year":"2011","journal-title":"Circulation"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"544","DOI":"10.7326\/0003-4819-120-7-199404010-00003","article-title":"Autoantibody-associated congenital heart 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hydroxychloroquine is associated with a reduced risk of recurrent anti-SSA\/Ro-antibody-associated cardiac manifestations of neonatal lupus","volume":"126","author":"P M Izmirly","year":"2012","journal-title":"Circulation"},{"issue":"13","key":"ref12","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.jacc.2010.12.014","article-title":"Prolongation of the atrioventricular conduction in fetuses exposed to maternal anti-Ro\/SSA and anti-La\/SSB antibodies did not predict progressive heart block. A prospective observational study on the effects of maternal antibodies on 165 fetuses","volume":"57","author":"E T Jaeggi","year":"2011","journal-title":"J Am Coll Cardiol"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/S0735-1097(00)01048-2","article-title":"Congenital heart block: development of late-onset cardiomyopathy, a previously underappreciated sequela","volume":"37","author":"J P Moak","year":"2001","journal-title":"J Am Coll Cardiol"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/ar1690","article-title":"Anti-SSA\/Ro antibodies and the heart: more than complete congenital heart block? A review of electrocardiographic and myocardial abnormalities and of treatment options","volume":"7","author":"N Costedoat-Chalumeau","year":"2005","journal-title":"Arthritis Res Ther"},{"issue":"08","key":"ref15","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1016\/j.jacc.2006.07.034","article-title":"Presentation and prognosis of complete atrioventricular block in childhood, according to maternal antibody status","volume":"48","author":"E Villain","year":"2006","journal-title":"J Am Coll Cardiol"},{"issue":"06","key":"ref16","first-page":"407","article-title":"Neonatal lupus erythematosus and its clinical variability","volume":"10","author":"M Inzinger","year":"2012","journal-title":"J Dtsch Dermatol Ges"},{"issue":"07","key":"ref17","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1111\/1756-185X.12652","article-title":"Neonatal lupus erythematosus: a review of 123 cases in China","volume":"18","author":"Y Q Li","year":"2015","journal-title":"Int J Rheum Dis"},{"issue":"10","key":"ref18","doi-asserted-by":"crossref","first-page":"3187","DOI":"10.1002\/art.20554","article-title":"Outcome of pregnancies in patients with anti-SSA\/Ro antibodies: a study of 165 pregnancies, with special focus on electrocardiographic variations in the children and comparison with a control group","volume":"50","author":"N Costedoat-Chalumeau","year":"2004","journal-title":"Arthritis Rheum"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1002\/art.27333","article-title":"Cutaneous manifestations of neonatal lupus and risk of subsequent congenital heart block","volume":"62","author":"P M Izmirly","year":"2010","journal-title":"Arthritis Rheum"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/BOR.0000000000000414","article-title":"Progress in the pathogenesis and treatment of cardiac manifestations of neonatal lupus","volume":"29","author":"P Izmirly","year":"2017","journal-title":"Curr Opin Rheumatol"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s12016-017-8653-0","article-title":"Neonatal systemic lupus erythematosus syndrome: a comprehensive review","volume":"53","author":"F Vanoni","year":"2017","journal-title":"Clin Rev Allergy Immunol"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1515\/jpm-2020-0543","article-title":"Neonatal lupus erythematosus - practical guidelines","volume":"49","author":"J M Derdulska","year":"2021","journal-title":"J Perinat Med"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"569","DOI":"10.3109\/14397595.2015.1106661","article-title":"Maternal predictive factors for fetal congenital heart block in pregnant mothers positive for anti-SS-A antibodies","volume":"26","author":"H Tsuboi","year":"2016","journal-title":"Mod Rheumatol"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.fertnstert.2015.09.007","article-title":"Assisted reproductive technology and the risk of pregnancy-related complications and adverse pregnancy outcomes in singleton pregnancies: a meta-analysis of cohort studies","volume":"105","author":"J Qin","year":"2016","journal-title":"Fertil Steril"},{"issue":"04","key":"ref25","first-page":"242","article-title":"Assisted reproductive technology or infertility: what underlies adverse outcomes? Lessons from the Massachusetts outcome study of assisted reproductive technology","volume":"3","author":"J E Stern","year":"2022","journal-title":"F S Rev"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1002\/art.10232","article-title":"A serologic marker for fetal risk of congenital heart block","volume":"46","author":"S Salomonsson","year":"2002","journal-title":"Arthritis Rheum"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"653","DOI":"10.3109\/s10165-012-0704-z","article-title":"The predictive value of anti-SS-A antibodies titration in pregnant women with fetal congenital heart block","volume":"23","author":"A Anami","year":"2013","journal-title":"Mod Rheumatol"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"64.e1","DOI":"10.1016\/j.ajog.2012.09.020","article-title":"Maternal autoantibody levels in congenital heart block and potential prophylaxis with antiinflammatory agents","volume":"208","author":"R D Tunks","year":"2013","journal-title":"Am J Obstet Gynecol"},{"issue":"09","key":"ref29","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/j.autrev.2017.07.013","article-title":"Clinical and pathologic implications of extending the spectrum of maternal autoantibodies reactive with ribonucleoproteins associated with cutaneous and now cardiac neonatal lupus from SSA\/Ro and SSB\/La to U1RNP","volume":"16","author":"P M Izmirly","year":"2017","journal-title":"Autoimmun Rev"},{"issue":"04","key":"ref30","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.4049\/jimmunol.0902248","article-title":"Ro60-associated single-stranded RNA links inflammation with fetal cardiac fibrosis via ligation of TLRs: a novel pathway to autoimmune-associated heart block","volume":"184","author":"R M Clancy","year":"2010","journal-title":"J Immunol"},{"issue":"35","key":"ref31","doi-asserted-by":"crossref","first-page":"30444","DOI":"10.1074\/jbc.M111.263657","article-title":"A novel role of endothelin-1 in linking Toll-like receptor 7-mediated inflammation to fibrosis in congenital heart block","volume":"286","author":"D Alvarez","year":"2011","journal-title":"J Biol Chem"},{"issue":"10","key":"ref32","doi-asserted-by":"crossref","first-page":"3068","DOI":"10.1002\/art.22157","article-title":"Antimalarial agents: closing the gate on Toll-like receptors?","volume":"54","author":"R Lafyatis","year":"2006","journal-title":"Arthritis Rheum"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"474","DOI":"10.2174\/138920012800166607","article-title":"Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn","volume":"13","author":"R Antonucci","year":"2012","journal-title":"Curr Drug Metab"},{"issue":"18","key":"ref34","doi-asserted-by":"crossref","first-page":"4370","DOI":"10.3390\/ijms20184370","article-title":"Molecular targets of aspirin and prevention of preeclampsia and their potential association with circulating extracellular vesicles during pregnancy","volume":"20","author":"S Dutta","year":"2019","journal-title":"Int J Mol Sci"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"172762","DOI":"10.1016\/j.ejphar.2019.172762","article-title":"Aspirin and its pleiotropic application","volume":"866","author":"J Hybiak","year":"2020","journal-title":"Eur J Pharmacol"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"95.e1","DOI":"10.1016\/j.ajog.2020.07.023","article-title":"Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study","volume":"224","author":"R Hastie","year":"2021","journal-title":"Am J Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2657-6178.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:53:13Z","timestamp":1781531593000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2657-6178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,17]]},"references-count":36,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2026,3,17]]},"published-print":{"date-parts":[[2026,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2657-6178","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7,17]]},"published":{"date-parts":[[2025,7,17]]}}}