The Effect And Safety Of Hydroxychloroquine In Pregnant Patient With Systemic Lupus Erythematosus

Objective:The objective of this study was to determine the influence of hydroxychloroquine on disease activity, pregnancy outcome and fetal outcome in pregnant patient with systemie lupus erythematosus.Method:Eighty-three selective pregnancies which were evaluated retrospectively from2003to2014in XiangYa hospital were divided into two groups:HCQ group and non-HCQ group. The lupus activity, pregnancy outcomes and fetal outcomes during pregnancy were compared between the two groups. The children of the SLE patients were followed up.Resulte:There were43pregnancies in HCQ group and40pregnancies in non-HCQ group. In HCQ group, lupus activity occurred in4pregnancies,2of19patients with lupus nephritis recurrence;7resulted in pregnancies loss,6resulted in premature delivery,7resulted in premature rupture of membranes and5resulted in oligohydramnios;1resulted in fetal congenital anomaly,3resulted in intrauterine distress,2resulted in limited growth,4resulted in low birth weight infants. In non-HCQ group, lupus activity occurred in13pregnancies,6of14patients with lupus nephritis recurrence;8resulted in pregnancies loss,8resulted in Premature delivery,7resulted in premature rupture of membranes and3resulted in oligohydramnios;1resulted in intrauterine distress,1resulted in limited growth,6resulted in low birth weight infants. The rates of lupus activity and lupus nephritis recurrence in HCQ group were significantly lower than those of non-HCQ group (P=0.013and P=0.042). The pregnancy outcome and fetal outcome of the two groups have no significant difference (P<0.05). In HCQ group,36children were followed up, of which1child was diagnosed with neonatal lupus,6children have positive antinuclear antibody and1child died for atelencephalia. In non-HCQ group,32children were followed up, of which1child was diagnosed with neonatal lupus,5children have positive antinuclear antibody.Conclusion:HCQ can decrease the rates of lupus activity and lupus nephritis recurrence in pregnant patient with systemic lupus erythematosus, without increasing the risk of adverse pregnancy and fetal outcomes.