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

Abstract

Objective

To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies.

Study Design

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.

Results

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.

Conclusions

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.

Keywords:

• Anti-SSA/Ro autoantibody
• pregnancy
• titer
• risk stratification
• rheumatic disease
• heart block

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant number RO1HD100929.