{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:08:30Z","timestamp":1792109310748,"version":"4.4.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2008,1,29]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Anti-SSA\/Ro\u2013associated third-degree congenital heart block is irreversible, prompting a search for early markers and effective therapy.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            One hundred twenty-seven pregnant women with anti-SSA\/Ro antibodies were enrolled; 95 completed an evaluable course in 98 pregnancies. The protocol included fetal echocardiograms performed weekly from 16 to 26 weeks\u2019 gestation and biweekly from 26 to 34 weeks. PR intervals &gt;150 ms were considered prolonged, consistent with first-degree block. Ninety-two fetuses had normal PR intervals. Neonatal lupus developed in 10 cases; 4 were neonatal lupus rash only. Three fetuses had third-degree block; none had a preceding abnormal PR interval, although in 2 fetuses &gt;1 week elapsed between echocardiographic evaluations. Tricuspid regurgitation preceded third-degree block in 1 fetus, and an atrial echodensity preceded block in a second. Two fetuses had PR intervals &gt;150 ms. Both were detected at or before 22 weeks, and each reversed within 1 week with 4 mg dexamethasone. The ECG of 1 additional newborn revealed a prolonged PR interval persistent at 3 years despite normal intervals throughout gestation. No first-degree block developed after a normal ECG at birth. Heart block occurred in 3 of 16 pregnancies (19%) in mothers with a previous child with congenital heart block and in 3 of 74 pregnancies (4%) in mothers without a previous child with congenital heart block or rash (\n            <jats:italic>P<\/jats:italic>\n            =0.067).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Prolongation of the PR interval was uncommon and did not precede more advanced block. There was a trend toward more congenital heart block in fetuses of women with previously affected offspring than those without previously affected offspring. Advanced block and cardiomyopathy can occur within 1 week of a normal echocardiogram without initial first-degree block. Echodensities and moderate\/severe tricuspid regurgitation merit attention as early signs of injury.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.107.707661","type":"journal-article","created":{"date-parts":[[2008,1,15]],"date-time":"2008-01-15T01:55:21Z","timestamp":1200362121000},"page":"485-493","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":282,"title":["Utility of Cardiac Monitoring in Fetuses at Risk for Congenital Heart Block"],"prefix":"10.1161","volume":"117","author":[{"given":"Deborah M.","family":"Friedman","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Copel","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudine","family":"Davis","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin K.L.","family":"Phoon","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie S.","family":"Glickstein","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill P.","family":"Buyon","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, and the Department of Pediatrics, Division of Pediatric Cardiology, New York Medical College, Valhalla, NY (D.M.F.); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (M.Y.K.); Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Conn (J.A.C.); Department of Medicine, Division of Rheumatology (C.D., J.P.B.) and Department of Pediatrics,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200108)44:8<1832::AID-ART320>3.0.CO;2-C"},{"key":"e_1_3_2_2_2","unstructured":"Buyon JP Clancy RM. Neonatal lupus. In: Wallace DJ Hahn BH eds. Dubois\u2019 Lupus Erythematosus. 7th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2006: 1058\u20131080."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.157.8.3317"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00161-2"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-7-199404010-00003"},{"key":"e_1_3_2_6_2","first-page":"1101","volume":"20","year":"1993","unstructured":"Silverman ED. Congenital heart block and neonatal lupus erythematosus: prevention is the goal. J Rheumatol. 1993; 20: 1101\u20131104.","journal-title":"J Rheumatol"},{"key":"e_1_3_2_7_2","first-page":"11","volume":"82","year":"1993","unstructured":"Julkunen H, Kaaja R, Wallgren E, Teramo K. Isolated congenital heart block: fetal and infant outcome and familial incidence of heart block. 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Subclass distribution of maternal and neonatal anti-SSA\/Ro and -SSB\/La antibodies in congenital heart block. 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