NEONATAL LUPUS LONG TERM OUTCOME IN CHILDREN AND ASYMPTOMATIC MOTHERS

In this article pathogenesis and Mechanism of Neonatal Lupus in human and animal model was reviewed and results of two case series of Neonatal Lupus was critiszed. It is postulated that Auto-Antibodies including SSb, SSA, has a role in pathogenesis of neonatal Lupus and SSB has major role. The results of clinical case series reveal that in mothers with neonatal Lupus delivery, most of them had connective tissue disease symptoms before or during pregnancies, mortality in babies with neonatal lupus was high. The leading cause of death was congestive heart Faliure and occur in first months of life. The risk of Neonatal Lupus in next pregnancy in mothers with one neonatal Lupus baby is high with incidence rate between 20-30%. We suggest that in mothers with high risk of neonatal Lupus-mother with previous history of neonatal Lupus delivery or positive SSA, SSB Auto-antibodies echocardiography of fetus must be done between 18-24 weeks of pregnancy and if it was abnormal dexamethasone or plasmaphoresis started. These mothers and Fetus should be Undersupervision by a team of Rheumatologist, Gynecologist, perinatologist and pediatrician during period of Pregnancy.