Which autoantibody in Sjögren's syndrome is associated with an increased risk of congenital heart block?

In Sjögren's syndrome, the presence of anti-Ro (also known as anti-SS-A) autoantibodies is significantly associated with an increased risk of congenital heart block, particularly in fetuses of mothers who are positive for these antibodies. This association stems from the ability of anti-Ro antibodies to cross the placenta and affect fetal cardiac tissue, leading to potentially serious complications such as heart block during development.

The mechanism involves the inflammatory process that these autoantibodies can initiate within the fetal conduction system, which may disrupt normal heart function. Research has shown that approximately 2-5% of infants born to mothers with anti-Ro antibodies may develop congenital heart block, emphasizing the clinical relevance of screening for these autoantibodies in pregnant women diagnosed with Sjögren’s syndrome.

While anti-cardiolipin antibodies are often noted in autoimmune conditions and may relate to an increased risk of thrombosis, they are not directly linked to congenital heart block. Anti-La (anti-SS-B) antibodies are also present in some patients with Sjögren’s syndrome but are not associated with fetal heart block. ANCA antibodies are primarily related to vasculitis and do not have a direct connection to the cardiac complications seen in Sjö