Hydroxychloroquine treatment during pregnancy in lupus patients is associated with lower risk of preeclampsia
- 10 April 2019
- journal article
- research article
- Published by SAGE Publications in Lupus
- Vol. 28 (6), 722-730
- https://doi.org/10.1177/0961203319843343
Abstract
Hydroxychloroquine (HCQ) is regarded as a mainstay in the treatment of systemic lupus erythematosus (SLE) because of its efficacy in preventing flares, achieving remission, and reducing overall mortality. However, the impact of HCQ on pregnancy outcomes remains controversial. We aimed to investigate the effect of HCQ on pregnancy outcomes in patients with SLE. We performed a retrospective cohort study of 151 pregnancies in 122 patients with SLE (80 pregnancies in the HCQ treatment group and 71 pregnancies in the HCQ nontreatment group). We reviewed baseline characteristics including maternal comorbidities such as antiphospholipid syndrome, lupus nephritis, and autoimmune hepatitis. Pregnancy outcomes (preeclampsia, preterm delivery, and fetal growth restriction) and neonatal outcomes (gestational age at delivery and birth weight) were compared between HCQ treatment and nontreatment groups. Preeclampsia was significantly less complicated (7.5% vs 19.7%, p = 0.032) and neonatal birth weight was significantly greater (2757.0 ± 583.5 g vs 2542.3 ± 908.3 g, p = 0.001) in the HCQ treatment group than in the HCQ nontreatment group. Multiple logistic analysis adjusting for body mass index (BMI), lupus nephritis, serum uric acid, and estimated glomerular filtration rate revealed HCQ treatment was associated with exceedingly lower risk of preeclampsia in SLE pregnancy (odds ratio (OR) 0.106 (confidence interval (CI) 0.017–0.671)). Other independent risk factors for preeclampsia were a high prepregnancy BMI (OR 1.575 (CI 1.114–2.227)) and low eGFR level (OR 0.931 (CI 0.886–0.979)) before pregnancy. Our data showed pregnancy outcomes in SLE patients can be improved in the HCQ treatment group with about 90% reduction of preeclampsia.Keywords
This publication has 41 references indexed in Scilit:
- Management of pregnancy in systemic lupus erythematosusNature Reviews Rheumatology, 2012
- Role of Endothelin in Mediating Soluble fms-Like Tyrosine Kinase 1–Induced Hypertension in Pregnant RatsHypertension, 2010
- Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseasesPediatric Rheumatology, 2009
- Role of TNF-α in vascular dysfunctionClinical Science, 2009
- A national study of the complications of lupus in pregnancyAmerican Journal of Obstetrics and Gynecology, 2008
- Placental Productions and Expressions of Soluble Endoglin, Soluble fms-Like Tyrosine Kinase Receptor-1, and Placental Growth Factor in Normal and Preeclamptic PregnanciesJournal of Clinical Endocrinology & Metabolism, 2008
- Oxidative stress increases placental and endothelial cell activin A secretionJournal of Endocrinology, 2007
- Enhanced Endothelin Synthesis by Endothelial Cells Exposed to Sera From Pregnant Rats With Decreased Uterine PerfusionHypertension, 2006
- Role of Endothelin in Mediating Tumor Necrosis Factor-Induced Hypertension in Pregnant RatsHypertension, 2005