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Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases.

Sperber K, Hom C, Chao CP, Shapiro D, Ash J - Pediatr Rheumatol Online J (2009)

Bottom Line: The OR of fetal deaths in women taking HCQ during pregnancy was 0.97 (95% CI 0.14, 6.54).The OR of pre-mature birth defined as birth before 37 weeks in women taking HCQ during pregnancy was 1.10 (95% CI 0.75, 1.61).HCQ is not associated with any increased risk of congenital defects, spontaneous abortions, fetal death, pre-maturity and decreased numbers of live births in patients with auto-immune diseases.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Allergy, Immunology, and Rheumatology, Department of Medicine, New York Medical College, Munger Pavilion, Valhalla, NY 10595, USA. kirk_sperber@NYMC.edu.

ABSTRACT

Objective: The purpose of this study is to compare the incidence of congenital defects, spontaneous abortions, number of live births, fetal death and pre-maturity in women with autoimmune diseases taking HCQ during pregnancy.

Methods: The authors searched MEDLINE, Cochrane data base, Ovid-Currents Clinical Medicine, Ovid-Embase:Drugs and Pharmacology, EBSCO, Web of Science, and SCOPUS using the search terms HCQ and/or pregnancy. We attempted to identify all clinical trials from 1980 to 2007 regardless of language or publication status. We also searched Cochrane Central Library and http://www.Clinical trials.gov for clinical trials of HCQ and pregnancy. Data were extracted onto standardized forms and were confirmed.

Results: The odds ratio (OR) of congenital defects in live births of women taking HCQ during pregnancy was 0.66, 95% confidence intervals (CI) 0.25, 1.75. The OR of a live birth for women taking HCQ during pregnancy was 1.05 (95% CI 0.58, 1.93). The OR of spontaneous abortion in women taking HCQ during pregnancy was 0.92 (95% CI 0.49, 1.72). The OR of fetal deaths in women taking HCQ during pregnancy was 0.97 (95% CI 0.14, 6.54). The OR of pre-mature birth defined as birth before 37 weeks in women taking HCQ during pregnancy was 1.10 (95% CI 0.75, 1.61).

Conclusion: HCQ is not associated with any increased risk of congenital defects, spontaneous abortions, fetal death, pre-maturity and decreased numbers of live births in patients with auto-immune diseases.

No MeSH data available.


Related in: MedlinePlus

OR of congenital defects and live births. The OR for congenital defects (2A)and live births (2B) from the pooled data in the HCQ group compared to the control group was determined.
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Figure 2: OR of congenital defects and live births. The OR for congenital defects (2A)and live births (2B) from the pooled data in the HCQ group compared to the control group was determined.

Mentions: Other studies have reported that HCQ is safe to use during pregnancy but had no control group [35-40]. All 4 of the studies [27-30] assessed the presence of congenital defects in babies born to women with autoimmune diseases (Additional file 1, Table S2 and Figure 2a). The OR for congenital defects for the pooled data for patients taking HCQ during pregnancy compared to no drug was 0.66 (95% CI, 0.25, 1.75) which favored HCQ (Additional file 1, Table S2 and Figure 2a).


Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases.

Sperber K, Hom C, Chao CP, Shapiro D, Ash J - Pediatr Rheumatol Online J (2009)

OR of congenital defects and live births. The OR for congenital defects (2A)and live births (2B) from the pooled data in the HCQ group compared to the control group was determined.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2690583&req=5

Figure 2: OR of congenital defects and live births. The OR for congenital defects (2A)and live births (2B) from the pooled data in the HCQ group compared to the control group was determined.
Mentions: Other studies have reported that HCQ is safe to use during pregnancy but had no control group [35-40]. All 4 of the studies [27-30] assessed the presence of congenital defects in babies born to women with autoimmune diseases (Additional file 1, Table S2 and Figure 2a). The OR for congenital defects for the pooled data for patients taking HCQ during pregnancy compared to no drug was 0.66 (95% CI, 0.25, 1.75) which favored HCQ (Additional file 1, Table S2 and Figure 2a).

Bottom Line: The OR of fetal deaths in women taking HCQ during pregnancy was 0.97 (95% CI 0.14, 6.54).The OR of pre-mature birth defined as birth before 37 weeks in women taking HCQ during pregnancy was 1.10 (95% CI 0.75, 1.61).HCQ is not associated with any increased risk of congenital defects, spontaneous abortions, fetal death, pre-maturity and decreased numbers of live births in patients with auto-immune diseases.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Allergy, Immunology, and Rheumatology, Department of Medicine, New York Medical College, Munger Pavilion, Valhalla, NY 10595, USA. kirk_sperber@NYMC.edu.

ABSTRACT

Objective: The purpose of this study is to compare the incidence of congenital defects, spontaneous abortions, number of live births, fetal death and pre-maturity in women with autoimmune diseases taking HCQ during pregnancy.

Methods: The authors searched MEDLINE, Cochrane data base, Ovid-Currents Clinical Medicine, Ovid-Embase:Drugs and Pharmacology, EBSCO, Web of Science, and SCOPUS using the search terms HCQ and/or pregnancy. We attempted to identify all clinical trials from 1980 to 2007 regardless of language or publication status. We also searched Cochrane Central Library and http://www.Clinical trials.gov for clinical trials of HCQ and pregnancy. Data were extracted onto standardized forms and were confirmed.

Results: The odds ratio (OR) of congenital defects in live births of women taking HCQ during pregnancy was 0.66, 95% confidence intervals (CI) 0.25, 1.75. The OR of a live birth for women taking HCQ during pregnancy was 1.05 (95% CI 0.58, 1.93). The OR of spontaneous abortion in women taking HCQ during pregnancy was 0.92 (95% CI 0.49, 1.72). The OR of fetal deaths in women taking HCQ during pregnancy was 0.97 (95% CI 0.14, 6.54). The OR of pre-mature birth defined as birth before 37 weeks in women taking HCQ during pregnancy was 1.10 (95% CI 0.75, 1.61).

Conclusion: HCQ is not associated with any increased risk of congenital defects, spontaneous abortions, fetal death, pre-maturity and decreased numbers of live births in patients with auto-immune diseases.

No MeSH data available.


Related in: MedlinePlus