中国新生儿红斑狼疮临床诊疗专家共识(2025)OA

Neonatal lupus erythematosus(NLE)is an acquired autoimmune disorder caused by the transplacental transfer of maternal autoantibodies to the fetus during pregnancy.NLE is diagnosed when the mother or infant tests positive for autoantibodies such as anti-Sjögren's syndrome A(SSA/Ro)or B(SSB/La)antibodies,or the mother has autoimmune diseases;and the fetus or neonate presents with cardiac,cutaneous,hepatic,or hematologic manifestations unexplained by other etiologies.Extracardiac manifestations of NLE are typically mild and self-limiting,often requiring no treatment.In contrast,cardiac involvement-particularly congenital heart block(CHB)carries a poor prognosis,with a mortality rate from 15%to 30%.Thus,CHB prevention has become the cornerstone of NLE management,encompassing both fetal cardiac surveillance and pharmacologic interventions during pregnancy,as well as postnatal therapies(e.g.,medication treatment and pacemaker implantation)for affected neonates.To improve survival and outcomes in CHB,the Neonatal Committee of the China Medicine Education Association developed this consensus,incorporating international evidence.Key recommendations include Hydroxychloroquine(400 mg·d-1)initiation before 12 gestational weeks for anti-SSA/Ro-positive pregnant women,updated criteria for epicardial pacing in low-birth-weight infants and anti-p200 antibody testing strategies.