Congenital heart block – maternal SLE — RACP Paediatrics MCQ

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HardCardiologyCongenital heart block – maternal SLERACP Paediatrics

A newborn with congenital complete heart block has a ventricular rate of 45 bpm. The mother has positive anti-Ro (SSA) and anti-La (SSB) antibodies. What is the most important maternal autoimmune condition to consider?

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Correct answer: A — Complete heart block

Neonatal congenital complete heart block is strongly associated with maternal anti-Ro/SSA and anti-La/SSB antibodies, which cross the placenta and damage the fetal conduction system. The mother may have systemic lupus erythematosus or Sjögren syndrome (sometimes subclinical). Many affected neonates require permanent pacemaker implantation.

Reference: RCH Melbourne – 2023 – Bradycardia CPG; RACP Paediatric Curriculum – Cardiology