Key result
Anti-Ro/La-negative congenital heart block was significantly less likely to present as complete block in utero compared to anti-Ro/La-positive cases (33.3% vs 94.4%, p<0.001) and was more often unstable.
Why the study?
Do clinical characteristics and outcomes differ between anti-Ro/La-negative and anti-Ro/La-positive congenital heart block in fetuses?
Observational (n=45)
Yes
Do clinical characteristics and outcomes differ between anti-Ro/La-negative and anti-Ro/La-positive congenital heart block in fetuses?
Absolute Event Rate: 33.3% vs 94.4%
p-value: p=<0.001
Anti-Ro/La-negative congenital heart block accounts for 20% of cases and presents with less stable and less complete block in utero compared to antibody-positive cases.
May warrant distinct fetal surveillance for anti-Ro/La-negative cases given instability; leaves open etiology-specific management pending prospective data.
OBJECTIVE: To study anti-Ro/La-negative congenital heart block (CHB). METHODS: Forty-five fetuses with CHB were evaluated by analysis of anti-Ro/La antibodies using sensitive laboratory methods. RESULTS: There were 9 cases of anti-Ro/La-negative CHB; 3 died (33.3%). Only 3 (33.3%) were complete in utero and 5 (55.5%) were unstable. No specific etiology was diagnosed. Six infants (66.6%) were given pacemakers. There were 36 cases of anti-Ro/La-positive CHB. All except 2 infants (94.4%) had complete atrioventricular block in utero. Ten died (27.8%), one (2.7%) developed severe dilated cardiomyopathy, and 26 (72.2%) were given pacemakers. CONCLUSION: Nine of the 45 consecutive CHB cases (20%) were anti-Ro/La-negative with no known cause. They were less stable and complete than the anti-Ro/La positive cases.
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Brucato et al. (2009) conducted an observational in Congenital heart block (n=45). Anti-Ro/La-negative maternal antibody status vs. Anti-Ro/La-positive maternal antibody status was evaluated on Complete atrioventricular block in utero (p=<0.001). Anti-Ro/La-negative congenital heart block was significantly less likely to present as complete block in utero compared to anti-Ro/La-positive cases (33.3% vs 94.4%, p<0.001) and was more often unstable.
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