Trial reportArthritis & rheumatology (Hoboken, N.J.)2024
Prospective Evaluation of High Titer Autoantibodies and Fetal Home Monitoring in the Detection of Atrioventricular Block Among Anti-SSA/Ro Pregnancies.
Trial report in Arthritis & rheumatology (Hoboken, N.J.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 26 citations in OpenAlex.
- Echogenicities in the Fetal Heart: Echocardiographic Evaluation, Differential Diagnosis and Clinical Outcomes.Pediatric cardiology · 2026Review
- Ambulatory Fetal Heart Rate and Rhythm Monitoring for Pregnancies at Risk for Fetal Arrhythmias: Perspectives from the Fetal Heart Society.Pediatric cardiology · 2026Review
- Fertility, pregnancy and lactation in women with systemic lupus erythematosus.Nature reviews. Rheumatology · 2026Review
- Association between maternal anti-Ro and anti-La antibody levels and congenital heart block: a 20-year cohort study.Archives of gynecology and obstetrics · 2026Article
- Blocking the neonatal Fc receptor as a novel approach to prevent cardiac neonatal lupus: a proof-of-concept study.Annals of the rheumatic diseases · 2026Article
- Neonatal lupus erythematosus: an acquired autoimmune disease to be taken seriously.Annals of medicine · 2025Review
- Effects of maternal anti-Ro/La antibodies on fetal atrioventricular conduction evaluated with echocardiography: a state-of-the-art review.Archives of gynecology and obstetrics · 2025Review
- Neonatal lupus erythematosus presenting with congenital heart block: clinical characteristics and follow-up.Clinical rheumatology · 2025Article
- Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2024Article
- Article
- Increased risk of adverse gestational outcomes in pregnant women with primary Sjögren's syndrome.RMD open · 2024Article
- Monitoring of Women with Anti-Ro/SSA and Anti-La/SSB Antibodies in Germany-Status Quo and Intensified Monitoring Concepts.Journal of clinical medicine · 2024Article
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Authors and funding
40 authors at 20 institutions in 2 countries.
Funding
Abstract
objectiveThis prospective study of pregnant patients, Surveillance To Prevent AV Block Likely to Occur Quickly (STOP BLOQ), addresses the impact of anti-SSA/Ro titers and utility of ambulatory monitoring in the detection of fetal second-degree atrioventricular block (AVB).
methodsWomen with anti-SSA/Ro autoantibodies by commercial testing were stratified into high and low anti-52-kD and/or 60-kD SSA/Ro titers applying at-risk thresholds defined by previous evaluation of AVB pregnancies. The high-titer group performed fetal heart rate and rhythm monitoring (FHRM) thrice daily and weekly/biweekly echocardiography from 17-26 weeks. Abnormal FHRM prompted urgent echocardiography to identify AVB.
resultsAnti-52-kD and/or 60-kD SSA/Ro met thresholds for monitoring in 261 of 413 participants (63%); for those, AVB frequency was 3.8%. No cases occurred with low titers. The incidence of AVB increased with higher levels, reaching 7.7% for those in the top quartile for anti-60-kD SSA/Ro, which increased to 27.3% in those with a previous child who had AVB. Based on levels from 15 participants with paired samples from both an AVB and a non-AVB pregnancy, healthy pregnancies were not explained by decreased titers. FHRM was considered abnormal in 45 of 30,920 recordings, 10 confirmed AVB by urgent echocardiogram, 7 being second-degree AVB, all <12 hours from normal FHRM and within another 0.75 to 4 hours to echocardiogram. The one participant with second/third-degree and two participants with third-degree AVB were diagnosed by urgent echocardiogram >17 to 72 hours from an FHRM. Surveillance echocardiograms detected no AVB when the preceding interval FHRM recordings were normal.
conclusionHigh-titer antibodies are associated with an increased incidence of AVB. Anti-SSA/Ro titers remain stable over time and do not explain the discordant recurrence rates, suggesting that other factors are required. Fetal heart rate and rhythm (FHRM) with results confirmed by a pediatric cardiologist reliably detects conduction abnormalities, which may reduce the need for serial echocardiograms.
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