Systemic Lupus Erythematosus: Perinatal Outcomes in Patients Treated With and Without Hydroxychloroquine

Article Figures & Data

Table 1.

Patient Demographics and Baseline Characteristics

Variable	Hydroxychloroquine Group, n=47	No Hydroxychloroquine Group, n=30	P value
Maternal age, years, mean ± SD	26.2 ± 5.2	30.5 ± 5.8	<0.01
Nulliparous	28 (60)	10 (33)	0.03
Race
White	10 (21)	15 (50)
Black	36 (77)	14 (47)	0.01
Other	1 (2)	1 (3)
Body mass index, kg/m², mean ± SD	29.0 ± 7.6	29.0 ± 6.9	0.97
Tobacco use	4 (9)	4 (13)	0.70
Alcohol use	0 (0)	0 (0)	–
Drug use	1 (2)	1 (3)	>0.99
Payment source
Private	13 (33)	10 (36)
Medicaid	27 (68)	15 (54)	0.10
Uninsured/self-pay	0 (0)	3 (11)
Marital status
Single	34 (72)	17 (57)	0.16
Married	13 (28)	13 (43)
Chronic hypertension	15 (32)	9 (30)	0.86
Received ongoing rheumatologic care	43 (91)	21 (70)	0.01
Diabetes mellitus	6 (13)	6 (20)	0.52
Gestational diabetes	2 (4)	3 (10)	0.37
Pregestational diabetes	4 (8)	3 (10)	>0.99
Prior cesarean delivery	7 (15)	3 (10)	0.73
Baseline serum creatinine, mg/dL, mean ± SD	0.75 ± 0.80^a	0.80 ± 0.58	0.76
Baseline systolic blood pressure, mmHg, mean ± SD	115.7 ± 16.1	118.3 ± 17.5	0.51
Baseline diastolic blood pressure, mmHg, mean ± SD	68.3 ± 9.8	70.4 ± 16.5	0.54
Baseline proteinuria (protein/creatinine ratio), mean ± SD	0.72 ± 1.59^b	0.42 ± 0.91^b	0.34
Delivery route
Vaginal	28 (60)	14 (47)	0.27
Cesarean	19 (40)	16 (53)
Prednisone use during pregnancy^c	39 (83)	12 (40)	<0.01
Aspirin use during pregnancy^d	33 (70)	20 (67)	0.74

Note: Data are presented as n (%) unless otherwise indicated.
↵^aNo negative values for baseline serum creatinine were noted. However, 0 was recorded for some baseline values.
↵^bNo negative values for baseline proteinuria were noted. However, 0 was recorded for some baseline values.
↵^cIncludes all patients prescribed prednisone for management of systemic lupus erythematosus anytime during pregnancy.
↵^dIncludes all patients prescribed low-dose daily aspirin for prophylaxis during pregnancy.

Table 2.

Maternal and Neonatal Outcomes

Variable	Hydroxychloroquine Group, n=47	No Hydroxychloroquine Group, n=30	P Value
Hypertensive disorders in pregnancy^a	14 (30)	8 (27)	0.77
Preeclampsia with severe features	9 (19)	7 (23)	0.66
Intrauterine growth restriction	1 (2)	3 (10)	0.29
Gestational weeks at delivery, mean ± SD	35.5 ± 4.9	35.6 ± 4.2	0.88
Preterm birth <37 weeks	19 (40)	16 (53)	0.27
Infectious complications	8 (17)^b	5 (17)	0.97
Chorioamnionitis	5 (11)	2 (7)	0.70
Endometritis	4 (9)	3 (10)	>0.99
Venous thromboembolism	2 (4)	0 (0)	0.52
Maternal death	2 (4)	1 (3)	>0.99
Inpatient consultation for rheumatology	18 (38)	3 (10)	0.007
Median number of consults (Q₁-Q₃)	1 (1-1)	2 (1-3)
Disease-related hospitalization during pregnancy	20 (43)	2 (7)	<0.001
Neonatal composite^c	18 (38)	15 (50)	0.31
Intrapartum fetal death	2 (4)	0 (0)	0.52
NICU admission >72 h	16 (34)	15 (50)	0.16
Mechanical ventilation >24 h	2 (4)	5 (17)	0.10
Suspected sepsis	5 (11)	1 (3)	0.40
Culture-proven early-onset sepsis	2 (4)	0 (0)	0.52
Neonatal death	1 (2)	1 (3)	>0.99
Grade III/IV intraventricular	0 (0)	0 (0)	–
hemorrhage
Hypoxic ischemic encephalopathy	1 (2)	0 (0)	>0.99
Respiratory distress syndrome	4 (9)	4 (13)	0.70
Seizures	0 (0)	0 (0)	–
Cardiopulmonary resuscitation	1 (2)	0 (0)	>0.99
Necrotizing enterocolitis	2 (4)	0 (0)	0.52

Notes: Data are presented as n (%) unless otherwise indicated. Because no maternal pregnancy or neonatal morbidities were statistically significant, no odds ratios or adjustments for age and parity are presented. The adjusted odds ratio of maternal disease-related morbidity is presented in the body of the text.
NICU, neonatal intensive care unit.
↵^aHypertensive disorders in pregnancy denotes any diagnosis of gestational hypertension or preeclampsia.
↵^bOne patient was treated for both chorioamnionitis and endometritis.
↵^cNeonatal composite includes the 12 listed outcomes.