Prenatal predisposing factors associated with neonatal lupus erythematosus
Issued Date
2022-01-01
Resource Type
ISSN
09612033
eISSN
14770962
Scopus ID
2-s2.0-85122311964
Pubmed ID
34978218
Journal Title
Lupus
Volume
31
Issue
1
Start Page
77
End Page
88
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lupus Vol.31 No.1 (2022) , 77-88
Suggested Citation
Anuwutnavin S. Prenatal predisposing factors associated with neonatal lupus erythematosus. Lupus Vol.31 No.1 (2022) , 77-88. 88. doi:10.1177/09612033211066455 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86709
Title
Prenatal predisposing factors associated with neonatal lupus erythematosus
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Objectives: To identify the prenatal predisposing factors related to neonatal lupus erythematosus (NLE). Materials and Methods: A retrospective case-control study was made of 131 pregnant women with positive anti-Ro or anti-La autoantibodies and known neonatal outcomes between January 2002 and December 2019 at Siriraj Hospital, Bangkok, Thailand. There were 101 unaffected neonates and 30 NLE cases confirmed postnatally. Demographic and clinical data of the mothers and neonates with and without NLE were statistically compared. Results: NLE was diagnosed in 30 out of 131 cases. A multivariate analysis identified the following significant factors for NLE: maternal anti-La antibodies (odds ratio (OR), 3.591; p = 0.030); and maternal treatment with either hydroxychloroquine (OR, 0.082; p = 0.001) or prednisolone (OR, 0.136; p = 0.017). Of the significant variables examined in the multivariate analysis models, high levels of maternal anti-La antibodies were found to be the strongest predictor of noncardiac NLE (OR, 4.558; p = 0.032), while a female baby was significantly higher in pregnancies complicated by cardiac NLE (OR, 5.374; p = 0.046). Hydroxychloroquine still provided a protective effect for both cardiac and noncardiac NLE (p = 0.039 and 0.032, respectively). Conclusions: The maternal anti-La antibodies were a beneficial predictor for NLE, especially as their high titers were influentially associated with noncardiac features. A female fetus seemed to present an increased risk for developing a congenital heart block. Nevertheless, the treatment with hydroxychloroquine during the pregnancies demonstrated a potentially protective factor against both cardiac and noncardiac manifestations.