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A large cohort study of pregnant and non-pregnant women with systemic lupus erythematosus has shown that lupus flares are increased during pregnancy and in the 3 months follwing delivery.
Investigators studied 1349 patients in the Hopkins Lupus Cohort between 14–45 years of age. They assessed disease activity an its relationship to pregnancy, postpartum or non-pregnant/non-postpartum periods. Among the 1349 patients, there were 398 pregnancies in 304 patients.
They found a 59% increased rate of lupus flare (defined by global assessment) during pregnancy (HR: 1.59).
The use of hydroxychloroquine (HCQ) during pregnancy influenced these outomces (compared with non-pregnant/non-postpartum periods):
- More Flares without HCQ use (HR 1.83; 95% CI 1.34 to 2.45) and
- Less Flares with HCQ use (HR 1.26; 95% CI 0.88 to 1.69)
This study shows that HCQ during pregnancy lessens the risk of flare during and after pregnancy.