Children born to mothers with systemic lupus erythematosus are likely to have one of the following anomalies –
**Core Concept**
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs, including the skin, joints, kidneys, and brain. Pregnant women with SLE are at increased risk of complications, which can affect the fetus. One of the potential anomalies associated with SLE in pregnancy is congenital heart block.
**Why the Correct Answer is Right**
Congenital heart block occurs when the electrical conduction system of the heart is disrupted, leading to a blockage in the heart's ability to conduct impulses. This can result in a slow heart rate, which may be life-threatening if not treated promptly. The exact mechanism of congenital heart block in SLE is not fully understood, but it is thought to be related to the presence of anti-Ro/SSA and anti-La/SSB antibodies, which can cross the placenta and affect the fetal heart. These antibodies can trigger an autoimmune response in the fetus, leading to the destruction of the heart's conduction system.
**Why Each Wrong Option is Incorrect**
* **Option A:** While SLE can increase the risk of preterm labor and low birth weight, it is not a specific anomaly that is directly associated with SLE.
* **Option B:** Cleft palate is not a common anomaly associated with SLE in pregnancy.
* **Option D:** While SLE can increase the risk of fetal growth restriction, it is not a specific anomaly that is directly associated with SLE.
**Clinical Pearl / High-Yield Fact**
Women with SLE who are planning to become pregnant should be closely monitored by a high-risk obstetrician and a rheumatologist to minimize the risk of complications. Regular ultrasound and fetal monitoring can help identify potential issues early on.
**Correct Answer: C. Congenital heart block.