ACR: Incidence of Atrioventricular Block Increased with High Levels of Anti-SSA/Ro Antibodies

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MONDAY, Nov. 13, 2023 (HealthDay News) — High levels of anti-SSA/Ro antibodies are associated with an increased incidence of fetal atrioventricular block (AVB), according to a study published online Nov. 10 in Arthritis & Rheumatology to coincide with the annual meeting of the American College of Rheumatology, held from Nov. 10 to 15 in San Diego.

Jill P. Buyon, M.D., from NYU Langone Heath in New York City, and colleagues examined the impact of anti-SSA/Ro antibody titers in the detection of fetal AVB. Women with anti-SSA/Ro antibodies were stratified into high and low anti-52kD and/or 60kD SSA/Ro titers. Fetal heart rate monitoring (FHRM) was performed three times a day in the high-risk group, and they underwent weekly/biweekly echocardiography from 17 to 26 weeks. Urgent echocardiography was performed in cases of abnormal FHRM.

In 261 of 413 individuals, anti-52kD and/or 60kD SSA/Ro met the thresholds for monitoring; AVB frequency was 3.8 percent in these individuals. The researchers observed no cases with low titers. With higher levels, the incidence of AVB increased, reaching 7.7 percent for those in the top quartile of anti-60kD SSA/Ro and 27.3 percent for those with a previous child with AVB. Healthy pregnancies were not explained by decreased titers in 15 individuals with paired samples from an AVB and non-AVB pregnancy. In 45 of 30,920 recordings, FHRM was considered abnormal; urgent echocardiography confirmed 10 as AVB (seven were second-degree; one was second/third-degree; and two were third-degree AVB).

“Women with low blood anti-SSA/Ro antibody levels may be able to safely forgo the cost, stress, and time needed for daily monitoring and routine ultrasound surveillance, with such screening reserved for only those with high blood anti-SSA/Ro antibody levels,” Buyon said in a statement.

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