title: Hydroxychloroquine and pregnancy on lupus flares in Korean patients with systemic lupus erythematosus.
abstract: We investigated the clinical and laboratory characteristics of pregnancies with systemic lupus erythematosus (SLE) and identified lupus flare predictors during pregnancy. Additionally, we examined lupus activity and pregnancy outcomes in SLE patients who continued, discontinued or underwent no hydroxychloroquine (HCQ) treatment during pregnancy. We retrospectively analyzed 179 pregnancies in 128 SLE patients at Seoul St. Mary's Hospital, Korea, between 1998 and 2012 and then assessed the clinical profiles and maternal and fetal outcomes. Overall, 90.5% of pregnancies resulted in a successful delivery and were divided into two groups: those who experienced lupus flares (80 pregnancies, 44.7%) and those who did not (99 pregnancies, 55.3%). Increased preeclampsia, preterm births, low birth weight, intrauterine growth restriction (IUGR), and low 1-minute Apgar scores occurred in pregnancies with lupus flares compared to pregnancies in quiescent disease. Lupus flares were predicted by HCQ discontinuation, a history of lupus nephritis, high pre-pregnancy serum uric acid and low C4 levels. Our study indicates that achieving pre-pregnancy remission and continuing HCQ treatment during pregnancy are important for preventing lupus flares.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine.
authors.forename: J H
authors.initials: JH
authors.lastname: Koh
authors.affiliation: Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Ko
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine.
authors.forename: S-K
authors.initials: SK
authors.lastname: Kwok
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine.
authors.forename: J H
authors.initials: JH
authors.lastname: Ju
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine rapark@catholic.ac.kr.
authors.forename: S-H
authors.initials: SH
authors.lastname: Park
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001034:Apgar Score; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000627:therapeutic use*; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008181:Lupus Nephritis / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000503:physiopathology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D056910:Republic of Korea; D012189:Retrospective Studies; D014527:Uric Acid / Q000097:blood
chemical_list: D018501:Antirheumatic Agents; D014527:Uric Acid; D006886:Hydroxychloroquine
keywords: Systemic lupus erythematosus; hydroxychloroquine; pregnancy