Predictive Factors of Fetal Cardiac Manifestations of Neonatal Lupus in Anti-SSA/Ro and/or SSB/La Antibody-Positive Pregnant Women.

The factors associated with the development of cardiac manifestations of neonatal lupus (cardiac-NL) in fetuses with positive anti-SSA/Ro and/or SSB/La (anti-SSA/SSB) antibodies are unclear. This study aimed to investigate the predictive factors of fetal cardiac-NL in anti-SSA/SSB antibody-positive pregnant women.A total of 669 pregnant women with positive anti-SSA/SSB antibodies were retrospectively included. We determined whether the fetus had cardiac-NL and collected relevant clinical data. Univariate and multivariate analyses were performed to analyze the correlation between fetal cardiac-NL and clinical characteristics.Among 669 pregnant women with positive anti-SSA/SSB antibody tests, 26 cases of fetal cardiac-NL occurred. Univariate analysis showed that fetal cardiac-NL was positively correlated with the assisted reproduction (odds ratio [OR]: 2.824; p = 0.045), strong positive anti-SSA/SSB antibody (OR: 6.437; p < 0.001), and clinical diagnosis of connective tissue disease (CTD; OR: 4.701; p = 0.037); it was negatively correlated with the use of hydroxychloroquine (HCQ; OR: 0.187; p < 0.001) and aspirin (OR: 0.369; p = 0.048). Multivariate analysis showed that the assisted reproduction (OR: 4.110; p = 0.029), strong positive anti-SSA/SSB antibody (OR: 8.691; p < 0.001), and clinical diagnosis of CTD (OR: 8.614; p = 0.010) were risk factors for fetal cardiac-NL; while HCQ (OR: 0.091; p < 0.001) and aspirin (OR: 0.318; p = 0.035) were protective factors for fetal cardiac-NL.This study determined that assisted reproduction, strong positive anti-SSA/SSB antibody, and clinical diagnosis of CTD are independent risk factors for fetal cardiac-NL. The use of HCQ and aspirin are independent protective factor for fetal cardiac-NL. · Anti-SSA/SSB antibodies can lead to fetal cardiac-NL.. · Assisted reproduction, strong positive anti-SSA/SSB antibodies, and CTD are risk factors.. · HCQ and aspirin use may lower the risk of fetal cardiac-NL..