SynthesisLupus science & medicine2022
Hydroxychloroquine in the pregnancies of women with lupus: a meta-analysis of individual participant data.
Synthesis in Lupus science & medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus.Current rheumatology reviews · 2025Guideline
- Effect of hydroxychloroquine on pregnancy outcome in patients with SLE: a systematic review and meta-analysis.Lupus science & medicine · 2024Pooled it
- Hydroxychloroquine levels in pregnancy and materno-fetal outcomes in systemic lupus erythematosus patients.Rheumatology (Oxford, England) · 2025Trial
- Hydroxychloroquine Exposure Intensity During Early Pregnancy and Composite Fetal Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- "Actionable" risk for preterm birth: patterns and prediction in California singleton births 2016-2020.BMC pregnancy and childbirth · 2026Article
- Second delivery rates and recurrence of adverse pregnancy outcomes in women with systemic lupus erythematosus: a nationwide population-based cohort study.Rheumatology (Oxford, England) · 2026Article
- Safety and clinical considerations of alopecia therapies during pregnancy, fertility treatment, and polycystic ovary syndrome workup.International journal of women's dermatology · 2026Review
- Hydroxychloroquine Use, Preeclampsia, and Preterm Delivery Complications in Systemic Lupus Erythematosus Pregnancies: Is There a Protective Effect?Arthritis care & research · 2026Article
- Toward Optimal Dosing in Systemic Lupus Erythematosus: The Case for Hydroxychloroquine Blood Level Monitoring.Arthritis care & research · 2026Article
- Article
- Hydroxychloroquine therapy for women with both recurrent pregnancy loss and autoimmune disease: association with pregnancy outcomes and maternal-fetal complications.Frontiers in immunology · 2026Article
- Immune profiling-informed immunomodulation associated with gestational extension in early-onset preeclampsia with monochorionic twins: a case report.Frontiers in immunology · 2026Article
- Exposure to hydroxychloroquine in early pregnancy and incidence of pre-eclampsia and pre-term delivery in patients with systemic lupus erythematosus in Sweden: a nationwide population-based cohort study.The Lancet. Rheumatology · 2025Article
- Risk of preterm delivery and early pregnancy hydroxychloroquine use from a Californian lupus cohort.Lupus science & medicine · 2025Article
- Current Approaches to the Management of Rheumatic Diseases in Pregnancy: Risk Stratification, Therapeutic Advances, and Maternal-Fetal Outcomes.Journal of personalized medicine · 2025Review
- Hydroxychloroquine in lupus or rheumatoid arthritis pregnancy and risk of major congenital malformations: a population-based cohort study.Rheumatology (Oxford, England) · 2025Article
- Hydroxychloroquine and Pre-eclampsia in a Diverse Cohort of Women With Systemic Lupus Erythematosus.Arthritis care & research · 2024Article
- Hydroxychloroquine as an Adjunct Therapy for Diabetes in Pregnancy.International journal of molecular sciences · 2024Review
- Rheumatoid Arthritis and Pregnancy: Managing Disease Activity and Fertility Concerns.Seminars in reproductive medicine · 2024Review
- Antimalarial Drugs at the Intersection of SARS-CoV-2 and Rheumatic Diseases: What Are the Potential Opportunities?Medicina (Kaunas, Lithuania) · 2024Review
Corrections and comments
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Authors and funding
15 authors at 9 institutions in 6 countries.
Funding
Abstract
objectiveMultiple guidelines recommend continuing hydroxychloroquine (HCQ) for SLE during pregnancy based on observational data. The goal of this individual patient data meta-analysis was to identify the potential benefits and harms of HCQ use within lupus pregnancies.
methodsEligible studies included prospectively collected pregnancies in women with lupus. After a systematic literature search, seven datasets meeting inclusion criteria were obtained. Pregnancy outcomes and lupus activity were compared for pregnancies with a visit in the first trimester in women who did or did not take HCQ throughout pregnancy. Birth defects were not systematically collected. This analysis was conducted in each dataset, and results were aggregated to provide a pooled OR.
resultsSeven cohorts provided 938 pregnancies in 804 women. After selecting one pregnancy per patient with a first trimester visit, 668 pregnancies were included; 63% took HCQ throughout pregnancy. Compared with pregnancies without HCQ, those with HCQ had lower odds of highly active lupus, but did not have different odds of fetal loss, preterm delivery or pre-eclampsia. Among women with low lupus activity, HCQ reduced the odds of preterm delivery.
conclusionsThis large study of prospectively-collected lupus pregnancies demonstrates a decrease in lupus activity among woman who continue HCQ through pregnancy and no harm to pregnancy outcomes. Like all studies of HCQ in lupus pregnancy, this study is confounded by indication and non-adherence. As this study confirms the safety of HCQ and diminished SLE activity with use, it is consistent with current recommendations to continue HCQ throughout pregnancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.