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Introduction <p>Complete Heart Block can lead to severe fetal complications. Maternal autoantibodies cross the placenta, increasing the risk of Fetal Complete Heart Block. This study investigates the prevalence of FCHB and the role of these autoantibodies in pregnant women with rheumatologic diseases in Bandar Abbas.</p> Methods <p>This retrospective, cross-sectional study was conducted in Southern Iran between 2021 and 2023. A total of 99 pregnant women with systemic lupus erythematosus, Sjögren’s syndrome, and rheumatoid arthritis, along with 4 cases of fetal bradycardia without maternal rheumatologic history, were referred for echocardiography. Among them, 63 had positive autoantibodies. Prophylactic treatment with hydroxychloroquine and/or prednisolone was administered, and treatment with dexamethasone, IVIG, and beta sympathomimetics was initiated based on echocardiographic findings and the timing of congenital heart block diagnosis.</p> Results <p>Out of 103 cases, 7 fetuses (0.6%) were diagnosed with congenital heart block. Four women had no prior rheumatologic history, while three had a history of systemic lupus erythematosus and rheumatoid arthritis. Seven women tested positive for autoantibodies. A significant correlation was found between CHB and anti-Ro antibodies (<i>P</i> = 0.017). Of the cases of fetal CHB, one developed hydrops fetalis, and six had CHB but normal cardiac function at birth.</p> Conclusion <p>Early diagnosis and timely intervention enhance outcomes in fetal congenital heart block, but many patients still require pacemakers, highlighting the importance of careful monitoring. Advancing risk stratification, exploring novel therapies, and conducting multicenter research are essential for optimizing management and further understanding the impact of maternal autoimmunity.</p>

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The Prevalence of Fetal Complete Heart Block and the Role of Positive Autoantibodies in Pregnant Women with Rheumatologic Diseases

  • 期刊论文

  • 发表日期：

    2025年9月10日

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  • Khadijeh Riazi Kermani,
  • Nazanin Abdi,
  • Razieh Moazami Goudarzi,
  • Zeynab Elahi,
  • Abolhasan Divband,
  • Shahrokh Rajaei,
  • Mohammad Reza Kargarfard Jahromi,
  • Fatemeh Arjmand

摘要

Introduction

Complete Heart Block can lead to severe fetal complications. Maternal autoantibodies cross the placenta, increasing the risk of Fetal Complete Heart Block. This study investigates the prevalence of FCHB and the role of these autoantibodies in pregnant women with rheumatologic diseases in Bandar Abbas.

Methods

This retrospective, cross-sectional study was conducted in Southern Iran between 2021 and 2023. A total of 99 pregnant women with systemic lupus erythematosus, Sjögren’s syndrome, and rheumatoid arthritis, along with 4 cases of fetal bradycardia without maternal rheumatologic history, were referred for echocardiography. Among them, 63 had positive autoantibodies. Prophylactic treatment with hydroxychloroquine and/or prednisolone was administered, and treatment with dexamethasone, IVIG, and beta sympathomimetics was initiated based on echocardiographic findings and the timing of congenital heart block diagnosis.

Results

Out of 103 cases, 7 fetuses (0.6%) were diagnosed with congenital heart block. Four women had no prior rheumatologic history, while three had a history of systemic lupus erythematosus and rheumatoid arthritis. Seven women tested positive for autoantibodies. A significant correlation was found between CHB and anti-Ro antibodies (P = 0.017). Of the cases of fetal CHB, one developed hydrops fetalis, and six had CHB but normal cardiac function at birth.

Conclusion

Early diagnosis and timely intervention enhance outcomes in fetal congenital heart block, but many patients still require pacemakers, highlighting the importance of careful monitoring. Advancing risk stratification, exploring novel therapies, and conducting multicenter research are essential for optimizing management and further understanding the impact of maternal autoimmunity.