Prevalence Of Anti-Ssa And Other Antinuclear Antibodies (Fana) In Healthy Pregnant-Women - Risk Markers For Congenital Heart-Block

Isolated congenital complete heart block (CCHB) is associated with SSA (Ro) antibodies (abs) from mothers with or without symptoms of rheumatic disease (RD). The frequency of SSA abs in pregnancy is not known. Also, obstetric care rarely includes an RD history. The purpose of this prospective study was to measure the prevalence of FANA and SSA abs in normal pregnancy, and to determine if maternal SSA abs, or RD history, define a group at risk to bear infants with CCHB. Sera from 190 pregnant women, collected by trimester, and after delivery, were tested by immunofluorescence (mouse kidney and Hep-2 cell substrates), and for anti-Sm, RNP, SSA, SSB, Scl-70, and PM-1 abs by immunodiffusion. 139 women were interviewed for personal or family RD histories, obstetric complications, and fetal outcome. 12/190 women had FANA on mouse kidney and 28 on Hep-2 cells; together, 34/190 sera had FANA (≥1:20);(15/34 1:80). In the 1st and 2nd trimesters, 17/105 sera had FANA, while the 3rd trimester exhibited 17/85 with FANA. Only 2/190 sera had SSA abs; mothers and infants were asymptomatic. Interview revealed RD in 6 mothers. RD family histories were found in 10/26 women with FANA, but only in 10/113 without FANA. There was no difference in the complication rate from prior pregnancies, in women with and without FANA. In summary, FANA is frequent in pregnancy, but is not associated with personal or familial occurrence of RD, or obstetric complications. The rarity of anti-SSA (2/190) in normal pregnancy contrasts with its specific association for infants with CCHB.