- 期刊
Newborns of Chinese Mother with Systemic Lupus Erythematosus (SLE)
系統性紅斑性狼瘡母親所生之新生兒
摘要
自民國68年l月至79年12月，對87例系統性紅斑性狼瘡母親之105次懷孕進行回溯性研究。其中流產、死胎及死產者共15次(14.29%)。90例活產中，23例(25.5%)屬中度早產，l例(l.1%)為極度早產。除2例(2.2%)外，所有新生兒之Apgar氏評分在l分鐘時均大於7分。沒有新生兒死亡之案例。 配對研究顯示這90例新生兒之出生體重顯著地較對照組為低。而出生之身長及頭圍則無顯著差異。13例(14.4%)新生兒出生時有發育遲滯現象。經追蹤後僅有l例身高，體重低於第3個百分點。 有3例(3.3%)出現先天性完全性房室傳導阻斷。其中1例必須使用心律調節器。他們的母親之SSA(Ro)抗體均為陽性反應。 其他有6例出現心電圖異常，包括：多發性心室早期收縮，遊走型心房節律，竇性心律不整，以及第一度房室傳導阻斷。後者持續存在於其中l例之心電圖中。 2例(2.2%)有第二型心房中隔缺損。 2例(2.2%)有狼瘡性皮疹。無血小板過少之案例。 在59例接受SSA抗體檢測之母親中，有29例(49.1%)為陽性反應。先天性完全性心房室傳導阻斷在此群中明顯增多。而胎兒流失之比例則顯著低於SSA抗體為陰性之母親。
關鍵字
無資料並列摘要
From January, 1979 to December, 1990, 105 pregnancies of the 87 mothers with systemic lupus erythematosus (SLE) were studied. There were 15 (14.29%) fetal losses. Among the 90 livebirths, 23 (25.5%) were moderately premature; and 1 (1.1%), was extremely premature. All but 2 (2.2%) had an Apgar score more than 7 at 1 minute. There was no neonatal death. Significantly lower birth body weights were noted compared with the matched control group (p=0.0001). Birth body length and head circumference were not different. Only 1 of the 13 newborns who had been small for gestational age at birth had body weight and length less than the 3rd percentile during follow-up. Three (3.3%) newborns presented as congenital complete atrioventricular block (CCAVB). Their mothers were all positive for SSA (Ro) antibody. One of them obligatorily needed pacemaker implantation. ECG abnormalities including multiple ventricular premature contractions, wandering atrial pacemaker, sinus arrhythmia, and first degree A-V block were detected in another six newborns. Congenital cardiac defect with secundum type atrial septal defect was noted in two newborns (2.2%). Among the 59 mothers who had been tested for SSA antibody, 29 (49.1%) were positive. The incidence of complete A-V block was significantly higher in newborns of mothers with SSA antibody (p＜0.001). On the contrary, the frequency of fetal loss has higher in newborns of mothers without SSA antibody (p=0.0043).