Effect of hydroxychloroquine on preeclampsia in lupus pregnancies: a propensity score-matched analysis and meta-analysis
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Effect of hydroxychloroquine on preeclampsia in lupus pregnancies: a propensity score‑matched analysis and meta‑analysis Yingnan Liu1 · Yueyi Zhang3 · Yumei Wei1,2 · Huixia Yang1,2 Received: 21 February 2020 / Accepted: 24 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Hydroxychloroquine (HCQ) is the primary medication in the treatment of pregnancy with systemic lupus erythematosus (SLE) for its efficacy and safety. However, the effect of HCQ on preeclampsia prevention remains controversial. Objective This study aimed to investigate whether HCQ has an effect on preeclampsia prevention and other pregnancy outcomes among lupus pregnancy. Methods We conducted a retrospective cohort study of 119 pregnant women with SLE. After the propensity score matching of baseline characteristics, the population was divided into the HCQ treatment group and HCQ nontreatment group. Then, we compared the preeclampsia and other pregnancy outcomes between HCQ treatment and nontreatment groups. Furthermore, we combined our data and previous studies for a meta-analysis. Results In our data, HCQ did not increase the risk of premature rupture of membranes, bleeding during pregnancy, preeclampsia, intrauterine distress, gestational age at delivery, preterm birth, and postpartum hemorrhage. There was no significant association between HCQ treatment and preeclampsia prevention. Besides, the meta-analysis showed a similar result that HCQ did not significantly decrease the rate of preeclampsia (RR = 0.61, 95%CI = 0.34–1.11). Conclusion This study found that HCQ treatment was safe, but did not significantly reduce preeclampsia among lupus pregnancies. Keywords Hydroxychloroquine · Preeclampsia · SLE · Propensity score matching · Meta-analysis Abbreviations HCQ Hydroxychloroquine SLE Systemic lupus erythematosus ET-1 Endothelin-1 ANA Antinuclear antibodies SSA Anti-Ro SSB Anti-La PSM Propensity score matching * Yumei Wei [email protected] * Huixia Yang [email protected] 1
Department of Obstetrics and Gynecology, Peking University First Hospital, Peking University, No. 1, Xi ‘anmen Street, Xicheng, Beijing, China
2
Beijing Key Laboratory of Maternal-Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
3
Department of Internal Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that often affects women of childbearing age [1]. Pregnant women with SLE often encounter with a couple of complications such as thrombosis and nephritis [2], and have a higher risk for certain pregnancy outcomes such as preeclampsia, fetal loss, as well as preterm delivery [3]. Despite the improved management of SLE pregnancies, the risk of developing preeclampsia remains three-to-four-fold higher compared to the general population [4]. Both SLE and preeclampsia are related to similar pathophysiology: chronic inflammation and oxidative s
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