Maternal antibodies to Ro/SSA and La/SSB confer risk of what in the neonate?

• A. Neonatal jaundice
• B. Tetralogy of Fallot
• C. Patent ductus arteriosus
• D. Neonatal lupus and congenital heart block

Answer: (D)

Maternal autoantibodies to Ro/SSA and La/SSB cross the placenta and cause inflammatory injury in the fetus, especially to the developing conduction system of the heart. This can lead to neonatal lupus with congenital heart block, which is the most significant and characteristic risk to the neonate. The block ranges from first- to complete-block and can persist after birth, sometimes requiring a pacemaker. Neonatal lupus can also present with cutaneous findings and liver involvement, but the hallmark and most specific fetal complication is congenital heart block.

Neonatal jaundice, while common for many reasons, is not a specific consequence of these antibodies. Structural congenital defects like tetralogy of Fallot or patent ductus arteriosus are not caused by these autoantibodies.