Hydroxychloroquine in early pregnancy: risk of birth defects
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Hydroxychloroquine in early pregnancy: risk of birth defects Use of hydroxychloroquine (HCQ) for the treatment of rheumatic disorders in early pregnancy appears to increase the risk of congenital abnormalities, according to findings of a US study published in the American Journal of Obstetrics and Gynecology. Data from Medicaid Analytic eXtract (2000–2014) and the IBM MarketScan Research Database (2003–2015) were used to investigate the risk of congenital abnormalities after in utero exposure to HCQ during the first trimester of pregnancy in women with rheumatic disorders. The study cohort included 1867 pregnancies exposed to HCQ and 19 080 propensity score-matched pregnancies with no use of HCQ. Infants were followed up for 3 months or longer after birth. Overall, the risk of major congenital abnormalities was significantly increased in infants exposed to HCQ compared with those with no HCQ exposure (adjusted relative risk [aRR] 1.26; 95% CI 1.04, 1.54). The risk was significantly increased after exposure to a dosage of 400 mg/day or greater (aRR 1.33; 95% CI 1.08, 1.65) but not after exposure to a dosage below 400 mg/day (aRR 0.95; 95% CI 0.60, 1.50). Point estimates found increases in the risks of oral clefts, respiratory abnormalities and urinary defects after exposure to HCQ. "In this study, there was no evidence of a large increase in prevalence of major congenital malformations in the newborn from first-trimester exposure to HCQ . . . For most patients with autoimmune rheumatic disorders, the benefits of treatment during pregnancy will likely outweigh this risk. If proven effective for COVID-19 prophylaxis in ongoing randomized trials, the benefits of HCQ would need to be weighed against the potential risk in pregnancy," concluded the authors. Huybrechts KF, et al. Hydroxychloroquine early in Pregnancy and Risk of Birth Defects. American Journal of Obstetrics and Gynecology : 19 Sep 2020. Available from: 803505514 URL: http://doi.org/10.1016/j.ajog.2020.09.007
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Reactions 3 Oct 2020 No. 1824
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