Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 37; no. 1; p. 2323623
• Main Authors: Howley, Lisa W, Eyerly-Webb, Stephanie A, Killen, Stacy A S, Paul, Erin, Krishnan, Anita, Gropler, Melanie R F, Drewes, Bailey, Dion, Eric, Lund, Amy, Buyon, Jill P, Cuneo, Bettina F
• Format: Journal Article
• Language: English
• Published: England 01.12.2024
• Subjects: Atrioventricular Block; Autoantibodies; Child; Female; Fetal Heart; Health Facilities; Humans; Pregnancy; Prenatal Care; Vitamins; heart block; titer; risk stratification; rheumatic disease; Anti-SSA/Ro autoantibody; pregnancy
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2024.2323623

To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies. An electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal Therapy Network members which queried institution-based risk stratification, surveillance methods/frequency, conduction abnormality treatments, and postnatal anti-SSA/Ro pregnancy assessment. 101 responses from 59 centers (59% US, 17% international) were collected. Most (79%) do not risk stratify pregnancies by anti-SSA/Ro titer; those that do use varied cutoff values. Many pregnant rheumatology patients are monitored for cardiac abnormalities regardless of maternal anti-SSA/Ro status. Surveillance strategies were based on maternal factors (anti-SSA/Ro status 85%, titer 25%, prior affected child 79%) and monitoring durations varied. Most respondents treat 2° and 3° fetal atrioventricular block, commonly with dexamethasone and/or IVIG. Wide variation exists in current fetal cardiac surveillance and treatment for anti-SSA/Ro autoantibody positive pregnancies, highlighting the need for evidence-based protocols to optimize care.