A Closer Look at Neonatal Lupus

Neonatal Lupus Can Cause Skin and Heart Disease

A newborn baby’s feet.
A newborn baby’s feet.. Christopher Furlong/Getty Images

Neonatal lupus is a rare form of lupus which is temporary and affects a fetus or newborn. Neonatal lupus occurs when the mother’s auto-antibodies are passed to her child in utero. These auto-antibodies can affect the skin, heart, and blood of the baby. Neonatal lupus sometimes appears as a rash developing soon after birth and can last several months before disappearing. This condition is not permanent; however, half of all babies born with neonatal lupus may present with a heart condition - one that is permanent, but treatable with a pacemaker.

Only about 1% of infants who receive positive maternal autoantibodies will develop neonatal lupus, and girls more often than boys. According to different reports, there is an 18% to 25% chance, however, that siblings born after an infant with neonatal lupus will also develop the disease. Mothers could also develop systemic lupus erythematosus (SLE) later in life, usually what’s referred to as an atypical rather and classic form of SLE.

How common is neonatal lupus?

Although the incidence of neonatal lupus is unknown, it can be estimated based on the number of congenital heart blocks that occur in newborns. Eighty percent of these heart blocks occur because of neonatal lupus. The number of cases of neonatal lupus is thus estimated at 1 of 12,500 live births.

Skin rashes in neonatal lupus

Nearly 75% of babies with neonatal lupus will have skin rashes at birth. The remaining 25% of infants will break out typically within two to five months.

Sun exposure tends to precipitate the outbreak, as well.

Rashes, on average, will disappear at about six months or soon after, as the mothers' auto-antibodies disappear from the infant.

Treatment for skin lesions is typically no more than ointments to help relieve the severity of the breakouts.

This picture of an infant with neonatal lupus demonstrates what neonatal lupus sink rashes look like.

Note that the baby’s eyes are electronically blacked out to protect his or her identity, and that may be disturbing to some viewers.

Heart disease in neonatal lupus

Congenital complete heart block is the most common cardiac rhythm abnormality that presents itself with neonatal lupus infants. This abnormality occurs around 15% to 30% of the time, and can be detected as early as the 18th week of pregnancy.

Does neonatal lupus increase the risk for adult lupus?

Fortunately, infants born with neonatal lupus are not at an increased risk of developing SLE later in life. However, if the mother has SLE, she is more likely to develop some form of autoimmune disease later in life, though not necessarily SLE.


Neonatal Lupus Erythematosus by Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School.

Neonatal lupus, by David T Robles, MD, PhD; Lorena Jaramillo, MD; and Robin L Hornung MD Dermatology Online Journal, Volume 12 Number 7.

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