Abstract
Background
Hydroxychloroquine (HCQ) is the primary medication in the treatment of pregnancy with systemic lupus erythematosus (SLE) for its efficacy and safety. However, the effect of HCQ on preeclampsia prevention remains controversial.
Objective
This study aimed to investigate whether HCQ has an effect on preeclampsia prevention and other pregnancy outcomes among lupus pregnancy.
Methods
We conducted a retrospective cohort study of 119 pregnant women with SLE. After the propensity score matching of baseline characteristics, the population was divided into the HCQ treatment group and HCQ nontreatment group. Then, we compared the preeclampsia and other pregnancy outcomes between HCQ treatment and nontreatment groups. Furthermore, we combined our data and previous studies for a meta-analysis.
Results
In our data, HCQ did not increase the risk of premature rupture of membranes, bleeding during pregnancy, preeclampsia, intrauterine distress, gestational age at delivery, preterm birth, and postpartum hemorrhage. There was no significant association between HCQ treatment and preeclampsia prevention. Besides, the meta-analysis showed a similar result that HCQ did not significantly decrease the rate of preeclampsia (RR = 0.61, 95%CI = 0.34–1.11).
Conclusion
This study found that HCQ treatment was safe, but did not significantly reduce preeclampsia among lupus pregnancies.
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Abbreviations
- HCQ:
-
Hydroxychloroquine
- SLE:
-
Systemic lupus erythematosus
- ET-1:
-
Endothelin-1
- ANA:
-
Antinuclear antibodies
- SSA:
-
Anti-Ro
- SSB:
-
Anti-La
- PSM:
-
Propensity score matching
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Funding
This study was supported by the Major Program of the National Key Research and Development Program of Reproductive Health & Major Birth Defects Control and Prevention (Grant No. 2016YFC1000402) to Y.W., the National Natural Science Foundation of China (Grant No. 81490745) to H.Y., the State Key Development Program for Basic Research of China (Grant No. 2015CB943304) to H.Y., the National Natural Science Foundation of China (Grant No. 81801467) to Y.W..
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YL: protocol, project development, data collection, data management, data analysis, manuscript writing, manuscript editing. YZ: data management, data analysis. YW: protocol, project development, data collection, manuscript editing. HY: protocol, project development, manuscript editing.
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The authors report no conflict of interest.
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Ethical approval from Medical Faculty Ethics Committee Peking University First Hospital was obtained: Approval number: 2013[578], Date: 01/12/2013.
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Liu, Y., Zhang, Y., Wei, Y. et al. Effect of hydroxychloroquine on preeclampsia in lupus pregnancies: a propensity score-matched analysis and meta-analysis. Arch Gynecol Obstet 303, 435–441 (2021). https://doi.org/10.1007/s00404-020-05762-5
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DOI: https://doi.org/10.1007/s00404-020-05762-5