The predictive value of anti-SS-A antibodies titration in pregnant women with fetal congenital heart block

• Published in: Modern rheumatology 2013-07, Vol.23 (4), p.653-658
• Main Authors: Anami, Ai, Fukushima, Kotaro, Takasaki, Yoshinari, Sumida, Takayuki, Waguri, Masako, Wake, Norio, Murashima, Atsuko
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Orthopedics; Rheumatology
• ISSN: 1439-7595; 1439-7609
• DOI: 10.1007/s10165-012-0704-z

Objective Fetal congenital complete heart block (CHB) is irreversible and is associated with significant mortality and morbidity. Anti-SS-A antibodies in the maternal sera are involved in its pathogenesis; however, the predictive value of the antibody titer and its role in prediction of this complication are controversial. The aim of this study was to determine the predictive value of maternal anti-SS-A antibodies on the development of fetal CHB. Methods A retrospective chart review was performed for 189 cases of positive anti-SS-A antibodies determined by the double immunodiffusion (DID) method, and included 17 patients that developed fetal CHB. The relationship between the appearance of CHB and the anti-SS-A antibodies titer was examined. Results An anti-SS-A antibodies titer of 1:32 or higher was identified by analyzing the receiver-operating characteristics (area under curve 0.72) curve. An anti-SS-A antibodies titer of 32 or more times greater than the upper limit by DID was a risk factor for fetal CHB (odds ratio 27.77, 95 % confidence interval (CI) 1.91–21.02, P