Predictive factors of fetal congenital heart block in anti-SS-A antibody-positive pregnant women

Background Identifying predictive factors of fetal congenital heart block (CHB) in pregnant women with positive anti-SS-A antibodies is important to manage the cases properly. Methods We retrospectively reviewed the medical records of 59 anti-SS-A antibody-positive women undergoing perinatal management at our hospital from January 2011 to November 2021. Univariate and multivariate analyses were performed to investigate predictive factors for the development of fetal CHB. Results Of 59 women with positive anti-SS-A antibodies, 9 had fetal CHB. In univariate analysis, fetal CHB was associated with diagnosing connective tissue disease (OR 0.109, p = .009) and positive anti-SS-A antibodies after conception (OR 31.333, p = .0002). In multivariate analysis, diagnosing connective tissue disease was a protective factor (OR 0.049, p = .025), and positive anti-SS-A antibody after conception was a risk factor (OR 41.738, p = .004). However, other maternal clinical characteristics did not influence the development of fetal CHB. Conclusions In pregnancies of anti-SS-A antibody-positive women, diagnosing connective tissue disease was an independent protective factor for fetal CHB, and positive anti-SS-A antibody after conception was an independent risk factor.