Hydroxychloroquine in lupus or rheumatoid arthritis pregnancy and risk of major congenital malformations: a population-based cohort study
2024

Hydroxychloroquine in Pregnancy and Risk of Birth Defects

Sample size: 3507 publication 10 minutes Evidence: moderate

Author Information

Author(s): Nguyen Ngoc V, Svenungsson Elisabet, Dominicus Annica, Altman Maria, Hellgren Karin, Simard Julia F, Arkema Elizabeth V

Primary Institution: Karolinska Institutet, Stockholm, Sweden

Hypothesis

Does first-trimester exposure to hydroxychloroquine increase the risk of major congenital malformations in infants born to mothers with systemic lupus erythematosus or rheumatoid arthritis?

Conclusion

First-trimester exposure to hydroxychloroquine was not associated with a significantly increased risk of major congenital malformations.

Supporting Evidence

  • 1007 births were included in the SLE cohort, with 453 exposed to hydroxychloroquine.
  • 2500 births were included in the RA cohort, with 144 exposed to hydroxychloroquine.
  • The adjusted risk ratios for SLE and RA cohorts were 1.29 and 1.32, respectively, indicating no significant increase in risk.

Takeaway

Taking hydroxychloroquine during the first three months of pregnancy doesn't seem to harm the baby, so it might be safe for mothers with certain diseases.

Methodology

This study analyzed data from Swedish nationwide registers, including singleton births from 2006 to 2021, comparing infants exposed to hydroxychloroquine during the first trimester to those unexposed.

Potential Biases

Potential misclassification of exposure and outcome due to reliance on prescription data without confirming actual use.

Limitations

The study did not include pregnancies that ended in abortion, which may have led to an underestimation of the risk of major congenital malformations.

Participant Demographics

The study included mothers with systemic lupus erythematosus or rheumatoid arthritis, with a mean age at conception of 31-33 years.

Statistical Information

Confidence Interval

95% CI: 0.65, 2.56 for SLE; 95% CI: 0.56, 3.13 for RA

Digital Object Identifier (DOI)

10.1093/rheumatology/keae168

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication