Clinical and serologic studies on three infants who had the neonatal lupus syndrome and studies on their mothers revealed an association with antibodies to sicca syndrome antigens. From initial studies and a 2-year follow-up, there is evidence that indicates transplacental passage of autoantibodies directed against Sjögren's (sicca) syndrome-associated nuclear antigens from asymptomatic mothers to newborns who subsequently developed neonatal lupus. Besides the presence of antinuclear antibodies, the mothers of these infants also showed high rheumatoid factor titers, and two had evidence of mild decreasing tearing on ophthalmologic examination. On follow-up examination 2 to 3 years later, both infants and mothers lacked evidence of active disease, and only the mothers continued to demonstrate the serologic abnormalities seen initially. Based on our findings, we postulate newborns of mothers with serologic or clinical evidence of Sjögren's (sicca) syndrome may be at greater risk for developing neonatal lupus.