Hydroxychloroquine is a medication used for certain medical conditions. When individuals who are pregnant or planning a pregnancy are prescribed this medication, concerns arise regarding its safety for both the parent and the developing baby. Understanding its role and safety data can address these concerns.
Hydroxychloroquine’s Therapeutic Uses During Pregnancy
Hydroxychloroquine is an antimalarial drug that also possesses immunomodulatory properties, meaning it can regulate the activity of the immune system. This makes it a valuable treatment for various autoimmune conditions where the immune system mistakenly attacks the body’s own tissues. It is commonly prescribed for conditions such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).
For individuals with these conditions, continuing hydroxychloroquine treatment throughout pregnancy is important for both maternal health and fetal well-being. Uncontrolled disease activity in conditions like lupus can lead to serious complications, including increased risks of preeclampsia, preterm birth, and fetal growth restriction. Maintaining treatment helps prevent disease flares, protect organs, and ultimately improve pregnancy outcomes.
Reviewing the Safety Data
Studies and clinical experience have evaluated hydroxychloroquine’s safety during pregnancy. Most research indicates it does not significantly increase the risk of major birth defects, miscarriage, or other adverse outcomes for the mother and fetus. For instance, a meta-analysis found no increased risk of congenital defects, spontaneous abortions, fetal death, prematurity, or decreased live births in patients with autoimmune diseases treated with hydroxychloroquine.
While some studies, particularly a large population-based cohort study, have suggested a small increased risk of major congenital malformations, especially with daily doses of 400 mg or more, many other studies have not found such an association. This potential small increase must be considered against the general population’s low background risk of birth defects, about 1 in 40 babies. The benefits of disease control often outweigh these potential risks.
Stopping hydroxychloroquine treatment during pregnancy can lead to increased disease activity and flares, which pose risks to both the pregnant individual and the baby. These risks include preeclampsia, premature labor, and other pregnancy complications. Its established safety record, based on decades of use, supports its continuation when medically indicated.
Navigating Treatment During Pregnancy
Medication decisions during pregnancy should always involve a healthcare provider. Individuals should discuss their circumstances with their rheumatologist, obstetrician, or other specialists when planning or during pregnancy. This collaboration ensures tailored treatment plans, considering the maternal condition, its activity, and overall health.
Abruptly stopping hydroxychloroquine without medical advice can be harmful, risking disease flares. Healthcare providers can explain the benefits of continuing treatment against any potential risks. Continuous monitoring for the pregnant individual and baby throughout pregnancy is typically part of managing autoimmune conditions. Open communication with the medical team about concerns or questions is encouraged for best outcomes.