Transplacental transfer of maternal antinuclear autoantibodies in neonatal lupus – the obstetrician’s perspective

Abstract

Neonatal lupus erythematosus (LEN) is an autoimmune disease caused by the transplacental transfer of autoantibodies to the fetus. An obstetrician can be confronted with mothers presenting antinuclear antibodies or fetal congenital heart block during pregnancy. The pathogenesis of neonatal lupus is not fully elucidated; however, the onset of the disease is related to the passive transplacental passage of maternal antinuclear autoantibodies, especially anti-Ro/SS-A and anti-La/SS-B. In this article, we provide a glimpse of the transport mechanism of maternal IgG class antibodies through the human placental and of the effects of transplacental transfer of maternal antinuclear autoantibodies in neonatal lupus. Good knowledge of pathogenic mechanisms and identifying patients at risk of neonatal lupus, with a complex interdisciplinary approach, may lead to better outcomes.