Risk of heart disease in neonates born to mothers with primary Sjögren's syndrome: a multicenter retrospective study.

Abstract

The impact of primary Sjögren's syndrome (pSS) on adverse pregnancy outcomes remains a debated issue. Research suggests that newborns of mothers with pSS may be at a higher risk of developing heart conditions. This study aimed to examine the relationship between maternal pSS and the risk of cardiac disorders in neonates. A multicentre, retrospective cohort study was conducted with pSS patients treated between January 2015 and May 2024. Data on demographics, comorbidities, disease activity, pregnancy outcomes and treatments were collected. Associations between adverse pregnancy outcomes and preconception characteristics were analysed. Among 169 newborns from pSS mothers, 49 had heart diseases, while 120 did not. Newborns with cardiac conditions had higher rates of premature birth (P = 0.002), lower birth weight (P = 0.012) and increased risk of neonatal asphyxia (P = 0.009), brain injury (P < 0.001) and neonatal infections (P < 0.001). Mothers who delivered babies with heart conditions had more umbilical cord abnormalities (P = 0.002) and threatened preterm labor (P = 0.008). Lower C3 and C4 levels (P = 0.022, P = 0.033) and use of glucocorticosteroids (P = 0.005) and ciclosporin A (P = 0.036) were linked to neonatal heart diseases. High EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) scores increased the risk of heart disease in newborns [OR 1.503, 95% CI (1.148, 1.966), P = 0.003]. Maternal pSS, especially with high disease activity, elevates the risk of neonatal heart disease, highlighting the need for careful monitoring during pregnancy.