{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:45:32Z","timestamp":1789076732246,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Transplacental fetal treatment of immune\u2010mediated fetal heart disease, including third\u2010degree atrioventricular block (AVB III) and endocardial fibroelastosis, is controversial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              To study the impact of routine transplacental fetal treatment, we reviewed 130 consecutive cases, including 108 with AVB III and 22 with other diagnoses (first\u2010degree\/second\u2010degree atrioventricular block [n=10]; isolated endocardial fibroelastosis [n=9]; atrial bradycardia [n=3]). Dexamethasone was started at a median of 22.4 gestational weeks. Additional treatment for AVB III included the use of a \u03b2\u2010agonist (n=47) and intravenous immune globulin (n=34). Fetal, neonatal, and 1\u2010year survival rates with AVB III were 95%, 93%, and 89%, respectively. Variables present at diagnosis that were associated with perinatal death included an atrial rate &lt;90\u00a0beats per minute (odds ratio [OR], 258.4; 95% CI, 11.5\u20135798.9;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), endocardial fibroelastosis (OR, 28.9; 95% CI, 1.6\u2013521.7;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), fetal hydrops (OR, 25.5; 95% CI, 4.4\u2013145.3;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), ventricular dysfunction (OR, 7.6; 95% CI, 1.5\u201339.4;\n              <jats:italic>P<\/jats:italic>\n              =0.03), and a ventricular rate &lt;45\u00a0beats per minute (OR, 12.9; 95% CI, 1.75\u201395.8;\n              <jats:italic>P<\/jats:italic>\n              =0.034). At a median follow\u2010up of 5.9\u00a0years, 85 of 100 neonatal survivors were paced, and 1 required a heart transplant for dilated cardiomyopathy. Cotreatment with intravenous immune globulin was used in 16 of 22 fetuses with diagnoses other than AVB III. Neonatal and 1\u2010year survival rates of this cohort were 100% and 95%, respectively. At a median age of 3.1\u00a0years, 5 of 21 children were paced, and all had normal ventricular function.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our findings reveal a low risk of perinatal mortality and postnatal cardiomyopathy in fetuses that received transplacental dexamethasone\u00b1other treatment from the time of a new diagnosis of immune\u2010mediated heart disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023000","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T03:11:15Z","timestamp":1641697875000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Outcome of Antibody\u2010Mediated Fetal Heart Disease With Standardized Anti\u2010Inflammatory Transplacental Treatment"],"prefix":"10.1161","volume":"11","author":[{"given":"Wadi","family":"Mawad","sequence":"first","affiliation":[{"name":"The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-3202","authenticated-orcid":false,"given":"Lisa","family":"Hornberger","sequence":"additional","affiliation":[{"name":"Stollery Children\u2019s Hospital University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-0882","authenticated-orcid":false,"given":"Bettina","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Denver CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Jos\u00e9e","family":"Raboisson","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire Sainte Justine Montr\u00e9al Quebec 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