Abstract / Summary
To evaluate the associations between hydroxychloroquine (HCQ) use and the risks of pre-eclampsia, hypertensive disorders of pregnancy (HDP), and preterm delivery in pregnant women with systemic lupus erythematosus (SLE). PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science were systematically searched from inception to May 30, 2024, for randomized controlled trials or observational studies investigating HCQ use in pregnant women with SLE. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analyses were performed using RevMan 5.1 software. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects models as appropriate. Nine studies were included in the meta-analysis. Compared with no HCQ use, HCQ use was not associated with statistically significant differences in the incidence of pre-eclampsia (4 studies, 1145 patients, OR = 1.11, 95% CI 0.60-2.06, P > 0.05), miscarriage (3 studies, 395 patients, OR = 1.27, 95% CI 0.72-2.25, P > 0.05), HDP (4 studies, 4787 patients, OR = 0.70, 95% CI 0.09-5.65, P > 0.05), or preterm delivery (9 studies, 2503 patients, OR = 0.78, 95% CI 0.44-1.39, P > 0.05). However, HCQ use was associated with a significantly lower risk of fetal growth restriction (FGR) (3 studies, 278 patients, OR = 0.41, 95% CI 0.18-0.93, P < 0.05) and gestational diabetes mellitus (GDM) (2 studies, 563 patients, OR = 0.28, 95% CI 0.17-0.48, P < 0.05). This meta-analysis demonstrated that hydroxychloroquine administration during pregnancy could not reduce the incidence of gestational complications. The results are inconsistent with those of previous primary studies, which may be attributed to the absence of parity-based stratification in the original studies. Accordingly, close attention should be paid to the adverse reactions of hydroxychloroquine, which should be used carefully. Further high-quality studies with subgroup analysis based on parity are strongly recommended in the future.
Primary Source
European journal of clinical pharmacology
Ask Prognia AI
Have questions about this meta-analysis?
Prognia AI can search this source alongside 35M+ PubMed papers and current ESC, AHA, NICE, and ADA guidelines to give you a fully cited clinical answer.