Anti-Ro/SSA antibodies and neonatal lupus
Are you a clinician? See the clinical version of this page.
- Hydroxychloroquine is a key part of lowering the risk to the baby's heart.
- Most anti-Ro pregnancies are not affected; the monitoring is a precaution.
What to know
What anti-Ro/SSA antibodies mean
These antibodies can be present in lupus, Sjogren's, or on their own. Most babies are fine, but a small number can be affected, so your pregnancy gets extra heart monitoring.
Heart block risk (baseline and recurrence)
The chance of a heart-rhythm problem is about 1 to 2 in 100 in a first affected pregnancy, and higher (about 15 to 20 in 100) if you have already had an affected baby.
Lowering the risk (hydroxychloroquine)
Hydroxychloroquine lowers the chance of heart block coming back if you have had an affected baby before, and is usually recommended.
Fetal heart monitoring
Your baby's heart rhythm is checked regularly with ultrasound, mostly between about 16 and 26 weeks, when the risk window is highest.
If a heart problem is found
If early changes in the baby's heart are seen, your team may consider specific medicines. This is decided case by case with fetal-heart specialists.
Neonatal lupus after birth
Some babies develop a temporary rash or, rarely, short-lived blood or liver changes after birth. These usually fade as the mother's antibodies clear from the baby.
The numbers, in plain terms
2 in 100
In a prospective study of 100 anti-Ro/SSA-positive women with a connective tissue disease, 2 in 100 babies were born with complete congenital heart block.
about 15 to 20 in 100
After a previously affected baby, the chance rises to about 15 to 20 in 100.
about 7 in 100
With hydroxychloroquine, recurrence of the more serious heart block fell to about 7 in 100 in a key study.
When to call your team
- Keep your fetal heart monitoring appointments; they are timed to the risk window.
- Do not stop hydroxychloroquine on your own.
- Report reduced baby movements or any concerns between scans.