Molecular Mechanisms of Fetal and Neonatal Lupus: A Narrative Review of an Autoimmune Disease Transferal across the Placenta.
Armando Di LudovicoMarta RinaldiFrancesca MainieriStefano Di MicheleVirginia GirlandoFrancesca CiarelliSaverio La BellaFrancesco ChiarelliMarina AttanasiAngela MauroEmanuele BizziAntonio Luca BrucatoLuciana BredaPublished in: International journal of molecular sciences (2024)
This study, conducted by searching keywords such as "maternal lupus", "neonatal lupus", and "congenital heart block" in databases including PubMed and Scopus, provides a detailed narrative review on fetal and neonatal lupus. Autoantibodies like anti-Ro/SSA and anti-La/SSB may cross the placenta and cause complications in neonates, such as congenital heart block (CHB). Management options involve hydroxychloroquine, which is able to counteract some of the adverse events, although the drug needs to be used carefully because of its impact on the QTc interval. Advanced pacing strategies for neonates with CHB, especially in severe forms like hydrops, are also assessed. This review emphasizes the need for interdisciplinary care by rheumatologists, obstetricians, and pediatricians in order to achieve the best maternal and neonatal health in lupus pregnancies. This multidisciplinary approach seeks to improve the outcomes and management of the disease, decreasing the burden on mothers and their infants.
Keyphrases
- systemic lupus erythematosus
- disease activity
- healthcare
- rheumatoid arthritis
- pregnancy outcomes
- multiple sclerosis
- risk factors
- low birth weight
- mental health
- palliative care
- drug induced
- preterm birth
- early onset
- pain management
- gestational age
- left ventricular
- insulin resistance
- physical activity
- electronic health record
- social media
- metabolic syndrome
- adverse drug
- climate change
- cardiac resynchronization therapy