Fetal safety of chloroquine and hydroxychloroquine use during pregnancy: A nationwide cohort study
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Fetal safety of chloroquine and hydroxychloroquine use during pregnancy : A nationwide cohort study. / Andersson, Niklas Worm; Skov, Lone; Andersen, Jon Trærup.
In: Rheumatology (United Kingdom), Vol. 60, No. 5, 2021, p. 2317-2326.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Fetal safety of chloroquine and hydroxychloroquine use during pregnancy
T2 - A nationwide cohort study
AU - Andersson, Niklas Worm
AU - Skov, Lone
AU - Andersen, Jon Trærup
N1 - Publisher Copyright: © 2020 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objective: The antimalaria 4-aminoquinoline drugs chloroquine and HCQ are used in the treatment of a wide range of CTDs. Data to inform on the safety of their use in pregnancy are limited. Methods: In a Danish nationwide cohort study from 1996 through 2016, we identified 4-aminoquinoline-exposed pregnancies from a cohort of 1240 875 pregnancies to investigate the associated risks of major birth defects, preterm birth, and small size for gestational age (SGA). Distinct study cohorts of propensity-score-matched 4-aminoquinoline-exposed and unexposed pregnancies (in a 1:1 ratio) were established for each outcome analysis. The association with the outcomes was assessed by prevalence odds ratios (ORs) estimated through logistic regression. The associated risks for chloroquine and HCQ were individually assessed through additional analyses. Results: A total of 1487 pregnancies exposed to 4-aminoquinolines (1184 chloroquine- A nd 303 HCQ-exposed) were identified. Among the 983 pregnancies exposed to 4-aminoquinolines in the first trimester, 34 infants (3.5%) were diagnosed with major birth defects as compared with 36 (3.7%) among the matched unexposed pregnancies (prevalence OR, 0.94; 95% CI: 0.59, 1.52). Exposure to 4-aminoquinolines in pregnancy was neither associated with an increased risk of preterm birth (prevalence OR, 0.97; 95% CI: 0.73, 1.28) or SGA (prevalence OR, 1.18; 95% CI: 0.93, 1.50), compared with unexposed pregnancies. No significant associations between exposure to chloroquine or HCQ individually and risk of the outcomes were identified. Conclusion: Among pregnancies exposed to 4-aminoquinolines (chloroquine and HCQ), no increased risk of major birth defects, preterm birth, or SGA was identified.
AB - Objective: The antimalaria 4-aminoquinoline drugs chloroquine and HCQ are used in the treatment of a wide range of CTDs. Data to inform on the safety of their use in pregnancy are limited. Methods: In a Danish nationwide cohort study from 1996 through 2016, we identified 4-aminoquinoline-exposed pregnancies from a cohort of 1240 875 pregnancies to investigate the associated risks of major birth defects, preterm birth, and small size for gestational age (SGA). Distinct study cohorts of propensity-score-matched 4-aminoquinoline-exposed and unexposed pregnancies (in a 1:1 ratio) were established for each outcome analysis. The association with the outcomes was assessed by prevalence odds ratios (ORs) estimated through logistic regression. The associated risks for chloroquine and HCQ were individually assessed through additional analyses. Results: A total of 1487 pregnancies exposed to 4-aminoquinolines (1184 chloroquine- A nd 303 HCQ-exposed) were identified. Among the 983 pregnancies exposed to 4-aminoquinolines in the first trimester, 34 infants (3.5%) were diagnosed with major birth defects as compared with 36 (3.7%) among the matched unexposed pregnancies (prevalence OR, 0.94; 95% CI: 0.59, 1.52). Exposure to 4-aminoquinolines in pregnancy was neither associated with an increased risk of preterm birth (prevalence OR, 0.97; 95% CI: 0.73, 1.28) or SGA (prevalence OR, 1.18; 95% CI: 0.93, 1.50), compared with unexposed pregnancies. No significant associations between exposure to chloroquine or HCQ individually and risk of the outcomes were identified. Conclusion: Among pregnancies exposed to 4-aminoquinolines (chloroquine and HCQ), no increased risk of major birth defects, preterm birth, or SGA was identified.
KW - 4-aminoquinolines
KW - fetal safety
KW - nationwide cohort study
KW - pregnancy
KW - propensity-score matching
UR - http://www.scopus.com/inward/record.url?scp=85104331072&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/keaa592
DO - 10.1093/rheumatology/keaa592
M3 - Journal article
C2 - 33232466
AN - SCOPUS:85104331072
VL - 60
SP - 2317
EP - 2326
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 5
ER -
ID: 304789921