Anti‐SS‐A antibodies and fetal outcome in maternal systemic lupus erythematosus

Ramsey‐Goldman, Rosalind; Hom, David L.; Deng, Jau‐Shyong; Ziegler, Gayle Casterline; Kahl, Leslie E.; Steen, Virginia D.; LaPorte, Ronald E.; Medsger, Thomas A.

doi:10.1002/art.1780291013

Cited by 157 publications

(54 citation statements)

References 9 publications

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“…It has been suggested that anti-Ro could lead to habitual abortion because of myocarditis or conduction defects in the fetus (23,24). However, in SLE patients, anti-Ro was not associated with fetal wastage (25). Our study did not find a single habitual aborter with anti-Ro.…”

Section: Discussioncontrasting

confidence: 75%

Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Petri

Golbus

Anderson

et al. 1987

Arthritis & Rheumatism

164

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In a controlled, prospective study of 44 consecutive women with idiopathic habitual abortion, only 5% had symptoms of rheumatic disease. Patients did not differ from control subjects in the frequency of positive results on tests for antinuclear antibody or anti-doublestranded DNA. Levels of C3 and C4 were higher in the habitual aborters. No patients had anti-Ro. The antiphospholipid antibody results were analyzed using 2 methods: the frequency of antiphospholipid antibodies was 9% by lupus anticoagulant using the Russell viper venom time (95% confidehce interval 22-2.5). and 11% by anticardiolipin antibody assay (95% confidence interval 25-3.7), which was not significantly different from that in control subjects. However, the mean levels in the aborters (although within the normal range) were Submitted for publication August 18, 1986; accepted in revised form January 7, 1987. significantly higher than those in control subjects for anti-double-stranded DNA (P = 0.004), lupus anticoagulant (by Russell viper venom time; P = 0.09), and anticardiolipin antibody (P = 0.0007), when examined by multiple linear regression analysis corrected for age and concurrent pregnancy. Of the 3 patients with antiphospholipid antibodies and subsequent successful pregnancies, only 1 was treated with prednisone and aspirin. We conclude that, in the majority of women, subclinical lupus, anti-Ro, the lupus anticoagulant, and anticardiolipin antibodies are not associated with idiopathic habitual abortion.Women with systemic lupus erythematosus (SLE) have an increased frequency of spontaneous abortions (1-4), but most women who habitually abort do not meet criteria for the diagnosis of SLE (5,6). No previous study has examined the frequency of laboratory findings that are generally associated with lupus (antinuclear antibodies [ANA], anti-Ro, lupus anticoagulant [LAC], and anticardiolipin [ACL] antibody among women with idiopathic habitual abortion ( 3 or more consecutive spontaneous abortions) compared with the frequency among normal controls. In the absence of controlled trials, it has been proposed that ANA, anti-Ro, LAC, and ACL, antibodies play a causal role in idiopathic habitual abortion and that treatment of the problems indicated by these laboratory findings may be necessary (7-10).We now report the frequency of ANA, antidouble-stranded DNA (dsDNA), anti-Sm, anti-RNP, anticentromere antibody, anti-Ro, anti-La, cornple-

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Section: Discussioncontrasting

confidence: 75%

Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Petri

Golbus

Anderson

et al. 1987

Arthritis & Rheumatism

164

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“…Response agreement was greater than 90% for verifiable data points (e.g.. dates of delivery and pregnancy outcomes). This questionnaire has been validated previously by a random sampling of hospital birth records, which showed agreement regarding pregnancy outcomes in 92% of the pregnancies reviewed (13). Similar reliability had been observed in comparisons of the histories described by the mothers and the records of their physicians (14).…”

Section: Methodssupporting

confidence: 55%

Pregnancy in women with systemic sclerosis

Steen

Conte

Day

et al. 1989

Arthritis & Rheumatism

Self Cite

123

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We assessed fetal morbidity and mortality in women with systemic sclerosis (SSc). Women with a history of SSc and a concomitant pregnancy completed a detailed questionnaire about the pregnancy. These 48 subjects were age‐matched and race‐matched to 2 other groups of women (a rheumatoid arthritis group and a control group from the same neighborhood), all of whom had been pregnant at least once. There were no differences in the frequencies of miscarriage or perinatal death in the SSc group compared with the 2 control groups. Preterm births occurred slightly more frequently in both SSc patients and rheumatoid arthritis patients compared with the neighborhood control subjects. There were significantly more small full‐term infants born to women with SSc. Interestingly, the increase in preterm births and small full‐term babies occurred with equal frequency prior to and after the onset of disease. Although close monitoring for premature birth and intrauterine growth retardation is necessary, we conclude that an uneventful, healthy pregnancy is possible for women with SSc. Those with early, rapidly progressive, diffuse skin thickening should avoid becoming pregnant since, intrinsically, they are at higher risk of developing renal crisis.

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“…In one retrospective study, 6 cases of heart block were reported in 96 pregnancies of 47 women with anti-SS-A/Ro antibodies. The antibodies had been identified by counterimmunoelectrophoresis of maternal sera, some of which were not obtained during pregnancy (25). The mothers of affected babies tended to have higher levels of anti-SS-A/Ro antibodies than did mothers of healthy children.…”

Section: Discussionmentioning

confidence: 99%