Division of Internal Medicine, Bordeaux University Hospital, 33000 Bordeaux, France.
Division of Rheumatology, Bordeaux University Hospital, 33000 Bordeaux, France.
Joint Bone Spine. 2018 Dec;85(6):663-668. doi: 10.1016/j.jbspin.2018.03.006. Epub 2018 Apr 6.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that primarily affects women of childbearing age. While the impact of hydroxychloroquine (HCQ) on SLE activity and neonatal lupus occurrence has been evaluated in several studies, its role on prematurity and intrauterine growth restriction (IUGR) remains uncertain. The aim of this study was to assess the impact of HCQ exposure on prematurity and IUGR during pregnancy in women with SLE.
We conducted a systematic review and a meta-analysis comparing prematurity and IUGR in SLE pregnancies exposed or not exposed to HCQ. The odds ratio of IUGR and prematurity were calculated and compared between pregnancies in each group according HCQ treatment.
Six studies were included (3 descriptive cohort studies and 3 case series) totalling 870 pregnancies. Of the SLE pregnancies, 308 were exposed to HCQ and were compared to 562 not exposed to HCQ. There was no statistical difference for prematurity or IUGR between groups.
This meta-analysis failed to prove the efficacy of HCQ in the prevention of prematurity as well as IUGR during SLE pregnancies. Due to the heterogeneity of the studies, these results should be interpreted cautiously.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，主要影响育龄妇女。已有多项研究评估了羟氯喹（HCQ）对 SLE 活动和新生儿狼疮发生的影响，但它对早产和宫内生长受限（IUGR）的作用仍不确定。本研究旨在评估 SLE 患者妊娠期间暴露于 HCQ 对早产和 IUGR 的影响。
我们进行了系统评价和荟萃分析，比较了暴露于 HCQ 和未暴露于 HCQ 的 SLE 妊娠中早产和 IUGR 的情况。根据 HCQ 治疗情况，计算并比较了每组妊娠中 IUGR 和早产的比值比。
共纳入 6 项研究（3 项描述性队列研究和 3 项病例系列研究），共计 870 例妊娠。在 SLE 妊娠中，有 308 例暴露于 HCQ，与 562 例未暴露于 HCQ 的妊娠进行比较。两组间早产或 IUGR 无统计学差异。
这项荟萃分析未能证明 HCQ 在预防 SLE 妊娠中早产和 IUGR 方面的疗效。由于研究的异质性，这些结果应谨慎解释。
