Anti-SSA/RO antibodies predict adverse pregnancy outcomes
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Key takeaways:
- Anti-SSA/RO antibodies may indicate risk for spontaneous abortion.
- Findings should be validated with real-world cohorts.
The presence of anti-SSA/RO antibodies in pregnant patients can predict adverse pregnancy outcomes, including spontaneous abortion, according to data published in Pediatric Rheumatology.
“Anti-SSA/RO, a crucial component of serological markers, is frequently used to diagnose Sjogren’s syndrome and systemic lupus erythematosus (SLE),” Xiangrui Sheng, MD, of the department of rheumatology at the First Affiliated Hospital of Soochow University, in Jiangsu, China, and colleagues wrote. “The management of pregnancy in women with autoimmune diseases is undoubtedly an integral part of the treatment of the disease.”
To investigate the connection between the presence of anti-SSA/RO antibodies and the maternal and infant outcomes of pregnant patients, Sheng and colleagues conducted a systematic literature review and meta-analysis. The researchers identified studies from the PubMed, Cochrane, Embase and Web of Science databases, published from 2000 through October 2022, using search terms including “anti-RO” or “anti-SSA,” as well as “pregnancy,” “pregnant woman,” “mothers,” “maternal” and “fetal.”
Real-world, observational studies of pregnancy outcomes in pregnant patients who were anti-SSA/RO-positive, and included research method breakdowns and specific data readouts, were included in the analysis.
The researchers analyzed two sets of endpoints. Maternal endpoints of interest included pregnancy termination, spontaneous abortion, preterm labor and cesarean operations, while fetal outcomes of interest were perinatal death, slow intrauterine growth, endocardial fibroelastosis, dilated cardiomyopathy, congenital heart block, congenital heart block recurrence and cutaneous neonatal lupus erythematosus.
The analysis included 890 papers representing 1,675 patients and 1,920 pregnancies. Regarding maternal outcomes, a pooled analysis estimated rates of 4% for pregnancy termination, 5% for spontaneous abortion, 26% for patients undergoing preterm labor and 50% for cesarean operations, according to the researchers.
Regarding fetal outcomes, the rate estimates were 4% for perinatal death, 3% for slow intrauterine growth and 6% for endocardial fibroelastosis. Additionally, 6% underwent dilated cardiomyopathy, 7% had a congenital heart block, 12% had a congenital heart block recur, 18% demonstrated cutaneous neonatal lupus erythematosus and 12% experienced hepatobiliary disease.
“This meta-analysis further clarifies the impact of anti-SSA/RO antibodies on maternal and infant outcomes during pregnancy,” Sheng and colleagues wrote. “Therefore, it 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.”
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