Maternal and infant outcomes of pregnancy associated with anti-SSA/RO antibodies: a systematic review and meta-analysis

Pediatr Rheumatol Online J. 2023 Mar 4;21(1):22. doi: 10.1186/s12969-023-00803-0.

Abstract

Objective: The relationship between anti-SSA/RO antibodies and pregnancy has been reported previously, and we aim to visualize the rates of maternal and infant outcomes with anti-SSA/RO.

Methods: We systematically searched records from Pubmed, Cochrane, Embase, and Web of Science databases, pooled incidence rates of adverse outcomes of pregnancy, and 95% confidence intervals (CIs) were performed with RStudio.

Results: A total of 890 records comprising 1675 patients and 1920 pregnancies were searched from the electronic databases. For maternal outcomes, the pooled estimate rates were 4% for termination of pregnancy, 5% for spontaneous abortion, 26% for preterm labor, and 50% for cesarean operation. While for fetal outcomes, the pooled estimate rates were 4% for perinatal death, 3% for intrauterine growth retardation, 6% for endocardial fibroelastosis, 6% for dilated cardiomyopathy, 7% for congenital heart block, 12% for congenital heart block recurrence, 19% for cutaneous neonatal lupus erythematosus, 12% for hepatobiliary disease and 16% for hematological manifestations. A subgroup analysis of congenital heart block prevalence was performed, diagnostic method and study region were found to affect heterogeneity to some extent.

Conclusion: Cumulative analysis of data from real-world studies confirmed adverse pregnancy outcomes of women with anti-SSA/RO, serves as a reference and a guide for the diagnosis and subsequent treatment of these women, thereby enhancing maternal and infant health. Additional studies with real-world cohorts are required to validate these results.

Keywords: Anti-SSA/RO; CHB; NLE; Pregnancy.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Abortion, Spontaneous*
  • Antibodies, Antinuclear
  • Cardiomyopathy, Dilated*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lupus Erythematosus, Cutaneous*
  • Pregnancy

Substances

  • SS-A antibodies
  • Antibodies, Antinuclear

Supplementary concepts

  • Congenital heart block