Early Hydroxychloroquine (Plaquenil) Use Offers No Protection Against Preeclampsia or Preterm Birth in Women with Systemic Lupus Erythematosus

A new study found early hydroxychloroquine (HCQ) use offers no protection against preeclampsia or preterm birth in women with systemic lupus erythematosus (SLE). HCQ (known commercially as Plaquenil®) is  widely used to manage SLE and recommended in reproductive guidelines, though its associations with pregnancy outcomes have been mixed. 

Researchers studied 847 singleton pregnancies, of which 597 were publicly insured women with SLE in British Columbia, Canada. Participants took HCQ during the first 20 weeks of their pregnancy with ≥2 fills or ≥60 days.  Of 303 pregnancies, 20 (6.6%) women who took HCQ experienced preeclampsia, and 20 (of 490; 4.1%) women who did not take HCQ experienced preeclampsia. The researchers calculated a risk ratio of 0.92 (95%) and the results were the same when they expanded the exposure window to include 3-months preconception. The researchers also found no association between HCQ use in the first 20-weeks of pregnancy and a reduced risk of preterm delivery at <34-weeks and <37-weeks. Overall, researchers found no evidence of increased risks from HCQ use during pregnancy.

A healthy pregnancy is possible for women with lupus, and HCQ is safe to continue taking if you become pregnant. Talk to your doctor before making any changes to your treatment. Learn more about pregnancy and lupus.

Read the study