The clinical diagnostic value of maternal autoantibodies against extractable nuclear antigens in fetal bradyarrhythmia


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Abstract

Autoantibodies against extractable nuclear antigens in mothers with autoimmune diseases (AID) or asymptomatic carriers may cause fetal bradyarrhythmia to the point of congenital heart block (CHB). Aim. To investigate the clinical diagnostic value of maternal autoantibodies against extractable nuclear antigens in fetal bradyarrhythmia. Materials and methods. The study included pregnant women with fetal bradyarrhythmia (group 1, n=15) and with regular fetal heart rhythm, who were divided into groups without (group 2, n=20) and with (group 3, n=10) AID. The women were tested for serum antinuclear antibodies (ANA), IgG antibodies against SSA/Ro, SSB/La, Sm, and double-stranded DNA using an enzyme immunoassay. Results. IgG antibodies against SSA/Ro and ANA were detected in 46.5% and 40% of women in group 1, which was 36.2 and 12.7 times more often than in group 2. These antibodies had a high diagnostic value in fetal atrioventricular heart block. Among pregnant women with fetal bradyarrhythmia, anti-SSA/Ro antibodies were detected more often than anti-SSB/La antibodies. Specific treatment of maternal AID contributed to the regular fetal heart rate. Conclusion. The detection of autoantibodies against SSA/Ro in asymptomatic carriers with fetal bradyarrhythmia and preventive CHB therapy can improve fetal outcomes.

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About the authors

Irina V. Menzhinskaya

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: i_menzinskaya@oparina4.ru
Dr.Med.Sci., Leading Researcher at the Laboratory of Clinical Immunology

Zulfiya S. Khodzhaeva

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: z_khodzhaeva@oparina4.ru
Khodzhaeva, Deputy Director of Obstetrics Institute

Ekaterina L. Bokeria

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: e_bokeriya@oparina4.ru
Dr.Med.Sci., Professor, Head of the 2nd Department of Pathology of Newborns and Premature Babies, Adviser to the Director

Natalia I. Klimenchenko

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: n_klimenchenko@oparina4.ru
Ph. D., Senior Researcher at the Department of Obstetric and Extragenital Pathology

Alena A. Potapova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: doc.PotapovaAA@yandex.ru
Ph.D. Student

Ludmila V. Van'ko

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: LVanko@oparina4.ru
Dr.Med.Sci., Professor, Leading Researcher at the Laboratory of Clinical Immunology

Lubov V. Krechetova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: l_krechetova@oparina4.ru
Dr.Med.Sci., Head of the Laboratory of Clinical Immunology

Nadezhda M. Kosheleva

V.A. Nasonova Research Institute of Rheumatology

Email: nadkosheleva@yandex.ru
Ph.D., Senior Researcher at the Laboratory of Systemic Rheumatic Diseases with a Group of Hemorheological Disorders

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