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 Sep;42(9):1161-1168. doi: 10.1038/s41372-022-01431-4. Epub 2022 Jun 18.

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.

MeSH terms

  • Betamethasone
  • Child
  • Female
  • Heart Block* / congenital
  • Heart Block* / therapy
  • Humans
  • Immunoglobulins, Intravenous* / therapeutic use
  • Infant, Newborn
  • Pregnancy
  • Steroids, Fluorinated

Substances

  • Immunoglobulins, Intravenous
  • Steroids, Fluorinated
  • Betamethasone

Supplementary concepts

  • Congenital heart block