Background Current treatment does not prevent all maternal, foetal and neonatal complications of antiphospholipid syndorme (APS), with an overall frequency of failure despite modern treatment ranges from 20 to 30%
Objectives To assess the pregnancy outcome in women with antiphospholipid antibody (aPL) treated with hydroxychloroquine (HCQ) during pregnancy
Methods This observational, retrospective, single centre clinical study included 170 pregnancies in 96 women with persistent aPL. Sixty-five consecutive pregnancies occurred in 31 women treated with HCQ for at least 6 months prior to pregnancy. HCQ was continued throughout gestation (group A). One-hundred nineteen consecutive pregnancies occurred in 65 women with aPL who had not been treated with HCQ prior to conception acted as controls (group B).
Results HCQ treatment was associated with a significantly higher rate of live births (66.7% in group A vs. 57.1% in group B, p=0.05) and a lower rate of pregnancy morbidity (47.1% in group A vs. 63.0% in group B, p=0.004). We observed a higher prevalence of spontaneous vaginal labour in HCQ-treated women compared to group B (37.3% vs. 14.3%, p=0.01). Pregnancy duration was longer in group A than B (27.6 [6-40] weeks vs. 21.5 [6-40], p=0.03). Fetal losses beyond 10 weeks gestation were less frequent in group A than B (2% vs 10.9%, p=0.05). Placenta mediated complications (pre-ecplampsia, abruption placenta and intrauterine growth restriction (IUGR)) were less prevalent in HCQ treated women compared to controls (2% vs. 10.9%, p=0.05).The association of HCQ with the absence of any complications in pregnancy was confirmed after multivariate analysis (OR 2.2; 95%CI [1.2-136.1]; p=0.04).
Conclusions Women with aPL may benefit of treatment with HCQ during pregnancy. The addition of HCQ to conventional treatment is worthy of further assessment.
Disclosure of Interest None declared