Cardiological Findings of Babies Born to Mothers with Connective Tissue Disease

Abstract

Objective: Cardiac conduction system is affected and heart blocks can be seen in newborns whose mothers have connective tissue disease, especially with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Anti-SS-A (Ro), anti-SS-B (La) antibodies in the mother's circulation are responsible for this situation. In this study, it was aimed to evaluate the clinical features and long-term follow-up results of babies born to mothers with connective tissue disease in our hospital. Materials and methods: Patients who were hospitalized in the neonatal intensive care unit between January 2001 and January 2016 due to the diagnosis of SLE, SS or connective tissue disease in their mothers were retrospectively screened, and their demographic and clinical characteristics and electrocardiographic findings were recorded. Results: A total of 49 babies from 48 mothers were included in the study. Mean age of mothers at birth was 30.8±5.0 years (28-41), mean gestational week of patients was 35.8±2.5 weeks (28-41), mean birth weight was 2614±680 g (730-3810 g). Ten newborns (20.4%) had 3rd degree atrioventricular (AV) block, and 1 baby had 1st degree AV block. Permanent pacemaker was implanted in five patients in the neonatal period, two of these patients died in the neonatal period. A pacemaker was inserted in a patient who was followed up with AV block in the 6th month. One baby who had no cardiac conduction problem died due to reasons related to prematurity. The mean follow-up period of 46 living babies was 4.6±3.1 (1.2-10.75) years, and the follow-up period of the patients with complete AV block and without a pacemaker was 5.6±2 years. Conclusion: Complete AV block in the neonatal period is a serious cardiac problem that requires rapid intervention. Expectant mothers with known connective tissue disease should be followed in tertiary care centers and the fetus should be followed closely. It is possible for newborns in need to return to their normal lives by inserting pacemakers.