Maternal lupus erythematosus is commonly associated with which congenital finding?

• A. Congenital heart block
• B. Endocardial cushion defect
• C. Ventricular septal defect
• D. Patent ductus arteriosus

Answer: (A)

Maternal lupus involves antibodies—especially anti-Ro/SSA and anti-La/SSB—that can cross the placenta and target the fetal conduction system. This immune attack often damages the fetal AV node and surrounding conducting tissue, leading to congenital heart block, typically a complete (third-degree) block. Because the injury to the conduction system can occur in utero, the finding is classically associated with neonatal or in-utero heart block rather than other structural defects.

Other defects listed are not characteristically linked to maternal lupus. Endocardial cushion defects appear more with chromosomal conditions like Down syndrome or maternal diabetes. Ventricular septal defects and patent ductus arteriosus are common congenital anomalies with various etiologies but not specifically tied to neonatal lupus. The distinctive and well-recognized association here is congenital heart block due to transplacental anti-Ro/SSA (and anti-La/SSB) antibodies.