Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
Table 2
Maternal and fetal pregnancy outcome according to HCQ treatment.
Total ()
Non-HCQ ()
HCQ ()
OR (95% CI)$$; value
Maternal outcome
Preeclampsia
13 (11.8)
9 (11.3)
2 (6.7)
1.0 (1.0-1.0); 0.57
Eclampsia
0 (0)
0 (0)
0 (0)
—
(i)HELLP
6 (5.5)
5 (6.3)
1 (3.3)
1.3 (0.1–17.9); 0.84
Prednisone use†
63 (57.3)
43 (53.8)
18 (60.0)
0.9 (0.7–1.2); 0.35
Prednisone < 7.5 mg within prednisone users
36 (32.7)
14 (17.5)
22 (73.3)
0.2 (0.0–1.4); 0.10
Fetal outcome
Early spontaneous abortion (<10 weeks of gestation)
19 (17.3)
10 (12.5)
9 (30.0)▲
1.5 (0.3–9.0); 0.66
Fetal death‡ (>10 weeks of gestation)
3 (2.7)
2 (2.5)
1 (3.3)
—
Preterm live birth
18 (16.4)
16 (20.0)
2 (6.7)
0.5 (0.1–2.4); 0.37
Of which <34 weeks
5 (4.5)
5 (6.3)
0 (0)
—
Term live birth
70 (63.6)
52 (65.0)
18 (60.0)
0.9 (0.3–2.7); 0.90
Small for gestational age
15 (13.6)
10 (12.5)
5 (16.7)
2.2 (0.6–7.5); 0.22
β (95% CI)$$; value
Duration of pregnancy (median, IQR)
38.9 (37.1–40.0)
38.9 (36.4–40.1)
38.7 (37.7–39.4)
−1 (−3.8 to 1.8); 0.48
Duration of pregnancy in preterm live births# (median, IQR)
35.1 (31.5–36.3)
34.9 (30.9–35.4)
36.8 (36.7-...)
2.4 (1.0–3.8); 0.001
Data depicted as numbers (%) unless otherwise indicated. HCQ: hydroxychloroquine; IQR: interquartile range; HELLP: (incomplete) hemolysis, elevated liver enzymes, and low platelet syndrome. $$Dependent variable: pregnancy outcome/prednisone use/duration of pregnancy. Predictor variable: HCQ use (ref = non-HCQ). Adjusted for antiphospholipid status, except for early spontaneous abortion. Pregnancies ending < 10 weeks of gestation were excluded (). †Prednisone dose was increased in 4.6% of pregnancies. ▲Of which, 5 occurred within one woman. ‡Two were due to elective termination, one because of trisomy 21 with Fallot’s tetralogy, and one because of infaust prognosis with severe preeclampsia, both occurring within the non-HCQ group. #() duration of pregnancy in weeks.
