Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies.
Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies.
复制标题
抗 SSA/Ro 自身抗体阳性妊娠的产前监测和管理的变化。
DOI：
10.1080/14767058.2024.2323623
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Cuneo,BettinaF
中科院分区：
文献类型：
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作者：
Howley,LisaW;Eyerly-Webb,StephanieA;Killen,StacyAS;Paul,Erin;Krishnan,Anita;Gropler,MelanieRF;Drewes,Bailey;Dion,Eric;Lund,Amy;Buyon,JillP;Cuneo,BettinaF
研究设计一份电子REDCap问卷被分发给胎儿心脏学会和北美胎儿治疗网络成员，询问基于机构的危险分层、监测方法/频率、传导异常治疗、结果共收集到来自59个中心（59%美国，17%国际）的101份回复。大多数（79%）没有通过抗SSA/Ro滴度对妊娠进行风险分层;那些使用不同的临界值。许多妊娠风湿病患者监测心脏异常，无论母亲抗SSA/Ro状态。监测策略基于母亲因素（抗SSA/Ro状态85%，滴度25%，既往受影响儿童79%），监测持续时间各不相同。大多数受访者治疗2°和3°胎儿房室传导阻滞，通常与地塞米松和/或IVIG.ConclusionsWide的变化存在于目前的胎儿心脏监测和治疗抗SSA/Ro自身抗体阳性妊娠，强调需要循证方案，以优化护理。
ObjectiveTo describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies.Study DesignAn electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal Therapy Network members which queried institution-based risk stratification, surveillance methods/frequency, conduction abnormality treatments, and postnatal anti-SSA/Ro pregnancy assessment.Results101 responses from 59 centers (59% US, 17% international) were collected. Most (79%) do not risk stratify pregnancies by anti-SSA/Ro titer; those that do use varied cutoff values. Many pregnant rheumatology patients are monitored for cardiac abnormalities regardless of maternal anti-SSA/Ro status. Surveillance strategies were based on maternal factors (anti-SSA/Ro status 85%, titer 25%, prior affected child 79%) and monitoring durations varied. Most respondents treat 2° and 3° fetal atrioventricular block, commonly with dexamethasone and/or IVIG.ConclusionsWide variation exists in current fetal cardiac surveillance and treatment for anti-SSA/Ro autoantibody positive pregnancies, highlighting the need for evidence-based protocols to optimize care.