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Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern

Ambrosi, Aurelie ; Salomonsson, Stina ; Eliasson, Hakan ; Zeffer, Elisabeth ; Skog, Amanda ; Dzikaite, Vijole ; Bergman, Gunnar ; Fernlund, Eva ; Tingstrom, Joanna and Theander, Elke LU , et al. (2012) In Annals of the Rheumatic Diseases 71(3). p.334-340
Abstract
Objective Congenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10-20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort. Methods The influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies. Results There was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity... (More)
Objective Congenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10-20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort. Methods The influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies. Results There was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity did not influence the development of heart block in either group. Maternal age in Ro/La-positive pregnancies with a child affected by heart block was, however, significantly higher than in pregnancies resulting in babies without heart block (p<0.05). Seasonal timing of pregnancy influenced the outcome. Gestational susceptibility weeks 18-24 occurring during January-March correlated with a higher proportion of children with heart block and lower vitamin D levels during the same period in a representative sample of Swedish women and a corresponding higher proportion of children with heart block born in the summer (p<0.02). Maternal age or seasonal timing of pregnancy did not affect the outcome in Ro/La-negative pregnancies. Conclusion This study identifies maternal age and seasonal timing of pregnancy as novel risk factors for heart block development in children of Ro/La-positive women. These observations may be useful for counselling when pregnancy is considered. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
71
issue
3
pages
334 - 340
publisher
BMJ Publishing Group
external identifiers
  • wos:000300039700004
  • scopus:84857237951
  • pmid:21953338
ISSN
1468-2060
DOI
10.1136/annrheumdis-2011-200207
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Rheumatology Research Unit (013243310), Emergency medicine/Medicine/Surgery (013240200)
id
10a216db-6613-4857-9748-02c75419e7bb (old id 2409726)
date added to LUP
2016-04-01 13:53:23
date last changed
2022-05-07 19:51:53
@article{10a216db-6613-4857-9748-02c75419e7bb,
  abstract     = {{Objective Congenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10-20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort. Methods The influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies. Results There was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity did not influence the development of heart block in either group. Maternal age in Ro/La-positive pregnancies with a child affected by heart block was, however, significantly higher than in pregnancies resulting in babies without heart block (p&lt;0.05). Seasonal timing of pregnancy influenced the outcome. Gestational susceptibility weeks 18-24 occurring during January-March correlated with a higher proportion of children with heart block and lower vitamin D levels during the same period in a representative sample of Swedish women and a corresponding higher proportion of children with heart block born in the summer (p&lt;0.02). Maternal age or seasonal timing of pregnancy did not affect the outcome in Ro/La-negative pregnancies. Conclusion This study identifies maternal age and seasonal timing of pregnancy as novel risk factors for heart block development in children of Ro/La-positive women. These observations may be useful for counselling when pregnancy is considered.}},
  author       = {{Ambrosi, Aurelie and Salomonsson, Stina and Eliasson, Hakan and Zeffer, Elisabeth and Skog, Amanda and Dzikaite, Vijole and Bergman, Gunnar and Fernlund, Eva and Tingstrom, Joanna and Theander, Elke and Rydberg, Annika and Skogh, Thomas and Ohman, Annika and Lundstrom, Ulla and Mellander, Mats and Winqvist, Ola and Fored, Michael and Ekbom, Anders and Alfredsson, Lars and Kallberg, Henrik and Olsson, Tomas and Gadler, Fredrik and Jonzon, Anders and Kockum, Ingrid and Sonesson, Sven-Erik and Wahren-Herlenius, Marie}},
  issn         = {{1468-2060}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{334--340}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Annals of the Rheumatic Diseases}},
  title        = {{Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern}},
  url          = {{http://dx.doi.org/10.1136/annrheumdis-2011-200207}},
  doi          = {{10.1136/annrheumdis-2011-200207}},
  volume       = {{71}},
  year         = {{2012}},
}