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Short and long-term outcomes of children with autoimmune congenital heart block treated with a combined maternal-neonatal therapy. A comparison study

Abstract

Objective

The short and long-term outcomes of children with anti-Ro/La-related congenital heart block treated with a combined maternal-neonatal therapy protocol were compared with those of controls treated with other therapies.

Study design

Sixteen mothers were treated during pregnancy with a therapy consisting of daily oral fluorinated steroids, weekly plasma exchange and fortnightly intravenous immunoglobulins and their neonates with intravenous immunoglobulins (study group); 19 mothers were treated with fluorinated steroids alone or associated to intravenous immunoglobulins or plasma exchange (control group).

Result

The combined-therapy children showed a significantly lower progression rate from 2nd to 3rd degree block at birth, a significant increase in heart rate at birth and a significantly lower number of pacemaker implants during post-natal follow-up with respect to those treated with the other therapies.

Conclusion

The combined therapy produced better short and long term outcomes with respect to the other therapies studied.

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Fig. 1: Comparison of the cumulative incidence of pacemaker implants in the infants of the two groups.

Data availability

Correspondence and requests for original data should be addressed to AR.

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Acknowledgements

The authors are grateful to Doctors Piero Marson, Tiziana Tison and Anna Colpo from Apheresis Unit, Department of Transfusion Medicine, University Hospital of Padua for their collaboration in the treatment of patients and to Mrs. Linda Inverso Moretti for editing the English version of this manuscript.

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Authors

Contributions

AR developed the project, and wrote the manuscript; AC performed echocardiograms in fetuses and in children during the post-natal follow-up and analyzed the data; MT performed laboratory assays and analyzed the data; MF, TDR, AC, MZ, CG, AH acquired data, and played an important role in interpreting the results; GDS critically reviewed the manuscript. All authors reviewed the manuscript for important intellectual contents and approved the final version. All authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Amelia Ruffatti.

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The authors declare no competing interests.

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Ruffatti, A., Cerutti, A., Tonello, M. et al. Short and long-term outcomes of children with autoimmune congenital heart block treated with a combined maternal-neonatal therapy. A comparison study. J Perinatol (2022). https://doi.org/10.1038/s41372-022-01431-4

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  • DOI: https://doi.org/10.1038/s41372-022-01431-4

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