Evidence map›Paper›PMID 41027685›Full record

ArticleLupus science & medicine2025

Risk of preterm delivery and early pregnancy hydroxychloroquine use from a Californian lupus cohort.

Amadeia Rector, Emily F Liu, Maurice Druzin, Michael H Weisman, Eliza Chakravarty, Miranda Cantu, Gary M Shaw, Daniel Z Kuo, Monique M Hedderson, Julia F Simard

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lupus science & medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Amadeia RectorEpidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.
Emily F LiuDivision of Research, Kaiser Permanente LLC, Oakland, California, USA.
Maurice DruzinObstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA.
Michael H WeismanMedicine, Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA.
Eliza ChakravartyArthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.
Miranda CantuGlobal Lupus Support Group, Portage, Michigan, USA.
Gary M ShawStanford University School of Medicine, Stanford, California, USA.
Daniel Z KuoRedwood City Medical Center, Kaiser Permanente LLC, Redwood City, California, USA.
Monique M HeddersonDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA.
Julia F SimardStanford University School of Medicine, Stanford, California, USA jsimard@stanford.edu.ORCID 0000-0001-5735-9856

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePregnant patients with systemic lupus erythematosus (SLE) have 2-3 times higher risk of preterm delivery (PTD). Hydroxychloroquine (HCQ) is recommended during pregnancy and may reduce PTD risk. This study investigates whether early pregnancy HCQ-use reduces PTD risk in a diverse SLE cohort.

methodsWe included singleton pregnancies reaching ≥20 weeks' gestation (2011-2020) among patients with SLE aged 18-50 receiving care at Kaiser Permanente Northern California. HCQ exposure was defined as ≥2 prescriptions filled from 3 months before the last menstrual period through the first trimester. PTD was defined as delivery <37 weeks and continuously as gestational weeks for time-to-delivery analyses. Propensity scores (PS) based on demographics, comorbidities and medication use were calculated to address confounding. Risk ratios (RR) and HRs, including 95% CIs, were estimated using PS-adjusted Poisson regression with robust SEs and Cox regression, stratified by parity. To investigate effect modification, we stratified by prepregnancy comorbidities and pregnancy corticosteroid use.

resultsAmong 399 pregnancies in 324 patients, 21% were preterm. The PS-adjusted RR was 1.08 (95% CI 0.52 to 2.23) and 0.88 (95% CI 0.50 to 1.57) for nulliparous and multiparous pregnancies exposed to HCQ, respectively. The PS-adjusted HRs were similar, and results remained consistent across analyses stratified by potential effect modifiers.

conclusionsAlthough periconceptional HCQ-use was not associated with reduced PTD nor appreciably altered gestational age at delivery, we found no increased risks for these specific adverse outcomes. Consistent with other work, we found potentially protective associations in subsets stratified by parity. However, we had limited statistical power to test this.

Indexed as

Antirheumatic AgentsHydroxychloroquineLupus Erythematosus, SystemicPregnancy ComplicationsPremature BirthAdolescentAdultCaliforniaCohort StudiesFemaleGestational AgeHumansMiddle AgedPregnancyRisk FactorsYoung AdultAntirheumatic AgentsHydroxychloroquineEpidemiologyHealth services researchLupus Erythematosus, Systemic

Identifiers

PMID41027685
PMCPMC12481301

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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.