Hydroxychloroquine in pregnant patients with systemic lupus erythematosus.

Abstract

To determine the safety for both mother and fetus of antimalarial drugs, i.e., chloroquine and hydroxychloroquine, in pregnant patients with lupus who continued antimalarial drugs throughout pregnancy. Stopping antimalarial drugs can precipitate disease flares of systemic lupus erythematosus (SLE), which are known to be detrimental to the outcome of pregnancy in patients with SLE. Stopping antimalarial drugs during pregnancy therefore not only puts the mother's health at risk but can also compromise the outcome of pregnancy. We document 9 pregnancies in 8 patients with lupus, all of whom took hydroxychloroquine (Plaquenil) throughout pregnancy. All 9 pregnancies, which occurred since our first report in 1988, resulted in 9 live births (4 full term and 5 preterm). No congenital abnormalities occurred and mean followup of 33 months (range 10-72 months) revealed no abnormalities in these children. Temporary discontinuation of hydroxychloroquine for 1 month precipitated a flare of disease in one mother, documented both clinically and serologically. It is safer to continue hydroxychloroquine rather than to discontinue this drug simply because of pregnancy.