Incidence and spectrum of neonatal lupus erythematosus: a prospective study of infants born to mothers with anti-Ro autoantibodies

J Pediatr. 2003 Jun;142(6):678-83. doi: 10.1067/mpd.2003.233.


Objective: Neonatal lupus erythematosus (NLE) is characterized by complete congenital heart block (CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with autoantibodies directed against SSA/Ro, SSB/La, or both. We carried out a prospective study to determine the incidence of individual NLE features.

Study design: The study was performed in two centers: Toronto, Canada, and Milano, Italy. Mothers had been referred for the presence of anti-SSA/Ro autoantibodies, regardless of their diagnosis. All the children were seen at least once within the first 6 months of life for clinical evaluation and laboratory testing. The study group consisted of 128 infants born from 124 pregnancies in 112 women with anti-Ro antibodies with or without anti-La antibodies.

Results: There were two cases of CCHB for an overall percentage of 1.6%. Twenty-one children (16%) developed cutaneous NLE. Laboratory testing showed hematologic abnormalities in 27% of the babies and elevation of liver enzymes in 26%.

Conclusions: Mothers with autoimmune diseases and anti-Ro antibodies are at risk of delivering a child with NLE but at a low risk of delivering a child with CCHB. Infants born to mothers with anti-Ro or anti-La antibodies should be monitored for other features of NLE in addition to CCHB.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / immunology
  • Autoantigens / immunology*
  • Autoimmune Diseases / immunology*
  • Female
  • Heart Block / congenital*
  • Heart Block / immunology
  • Humans
  • Incidence
  • Infant, Newborn
  • Lupus Erythematosus, Systemic / epidemiology*
  • Male
  • Pregnancy
  • Pregnancy Complications / immunology*
  • Prospective Studies
  • RNA, Small Cytoplasmic*
  • Ribonucleoproteins / immunology*


  • Autoantibodies
  • Autoantigens
  • RNA, Small Cytoplasmic
  • RO60 protein, human
  • Ribonucleoproteins
  • SS-A antigen