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MotherToBaby

Medications and More during pregnancy and breastfeeding

Hydroxychloroquine

Selected References:

  • Andersson NK, et al. 2021. Fetal safety of chloroquine and hydroxychloroquine use during pregnancy: a nationwide cohort study. Rheumatology (Oxford). 14;60(5):2317-2326. 
  • Bérard A, et al. 2021. Chloroquine and hydroxychloroquine use during pregnancy and the risk of adverse pregnancy outcomes using real-world evidence. Front Pharmacol. 12:722511. 
  • Berman A, et al. 2025. Hydroxychloroquine and pregnancy outcomes in patients with anti-phospholipid syndrome: a systematic review and meta-analysis. RMD Open. 11(3):e005825.  
  • Bermas BL, et al. 2018. Trends in use of hydroxychloroquine during pregnancy in systemic lupus erythematosus patients from 2001 to 2015. Lupus. 27(6):1012-1017.  
  • Buchanan NM, et al. 1996. Hydroxychloroquine and lupus pregnancy: review of a series of 36 cases. Ann Rheum Dis. 55(7):486-488.  
  • Centers for Disease Control and Prevention (CDC). 2024. Malaria. Available at URL: https://www.cdc.gov/malaria/index.html [Accessed April 2026] 
  • Centers for Disease Control and Prevention (CDC). 2024. Treatment of Malaria: Guidelines for Clinicians (United States): Alternatives for Pregnant Women. Available at URL: https://www.cdc.gov/malaria/hcp/clinical-guidance/pregnant-women.html [Accessed April 2026] 
  • Chambers CD, et al. 2022. Birth outcomes in women who have taken hydroxychloroquine during pregnancy: a prospective cohort study. Arthritis Rheumatol. 74(4):711-724.  
  • Cimaz R, et al. 2004. Electroretinograms of children born to mothers treated with hydroxychloroquine during pregnancy and breast-feeding: comment on the article by Costedoat-Chalumeau et al. Arthritis Rheum. 50(9):3056-3057. 
  • Clowse MEB, et al. 2006. Hydroxychloroquine in lupus pregnancy. Arthritis Rheum. 54(11):3640-3647.  
  • Costedoat-Chalumeau N, et al. 2003. Safety of hydroxychloroquine in pregnant patients with connective tissue diseases: a study of one hundred thirty-three cases compared with a control group. Arthritis Rheum. 48(11):3207-3211. 
  • Diav-Citrin O, et al. 2013. Pregnancy outcome following in utero exposure to hydroxychloroquine: a prospective comparative observational study. Reprod Toxicol. 39:58-62. 
  • Feldkamp M, Carey JC. 1993. Clinical teratology counseling and consultation case report: low dose methotrexate exposure in the early weeks of pregnancy. Teratology. 47(6):533-539. 
  • Flint J, et al. 2016. BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford). 55(9):1693-1697.  
  • Frassi M, et al. 2004. Hydroxychloroquine in pregnant patients with rheumatic disease: a case control observation of 76 treated pregnancies. Lupus 13(9):755. 
  • Howley MM, et al. 2021. Maternal exposure to hydroxychloroquine and birth defects. Birth Defects Res 113(17):1245-1256. 
  • Huybrechts KF, et al. 2021. Hydroxychloroquine early in pregnancy and risk of birth defects. Am J Obstet Gynecol. 224(3):290.e1-290.e22. 
  • Ingster-Moati I,  Albuisson E. 2010. Visual neurophysiological dysfunction in infants exposed to hydroxychloroquine in utero. Acta Paediatr. 99(1):4; author reply 4-5. 
  • Kaplan YC, et al. 2016. Reproductive outcomes following hydroxychloroquine use for autoimmune diseases: a systematic review and meta-analysis. Br J Clin Pharmacol. 81(5):835-848. 
  • Kroese SJ, et al. 2017. Hydroxychloroquine use in lupus patients during pregnancy is associated with longer pregnancy duration in preterm births. J Immunol Res. 2017:2810202. Levy RA, et al. 2001. Hydroxychloroquine (HCQ) in lupus
  • pregnancy: double-blind and placebo-controlled study. Lupus. 10(6):401-404. 
  • Mairesse R, et al. 2026. In utero exposure to medications and congenital eye anomalies. BMJ Open Ophthalmol. 11(1):e002049. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC12778234/pdf/bmjophth-11-1.pdf [Accessed April 2026] 
  • Mirzaei M, et al. 2023. The effects of hydroxychloroquine on pregnancy outcomes in infertile women: a systematic review and meta-analysis. J Med Life. 16(2):189-194. 
  • Mouyis M, et al. 2019. Safety of anti-rheumatic drugs in men trying to conceive: a systematic review and analysis of published evidence. Semin Arthritis Rheum. 48(5): 911-920. 
  • National Institutes of Health. 2021. Product label: hydroxychloroquine sulfate tablet. Available at URL: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=84b00366-96ef-41e1-bac6-5d24acdb9e1d. [Accessed April 2026] 
  • Rüegg L, et al. 2025. EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update. Ann Rheum Dis. 84(6):910-926.  
  • Sammaritano LR, et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol. 72(4):529-556.  
  • Silver R, et al. 2023. Society for Maternal-Fetal Medicine Consult Series #64: Systemic lupus erythematosus in pregnancy. Am J Obstet Gynecol. 228(3):B41-B60. 
  • Sperber K, et al. 2009. Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases. Pediatr Rheumatol Online J. 13:7:9. 
  • Tian Y, et al. 2021. The additional use of hydroxychloroquine can improve the live birth rate in pregnant women with persistent positive antiphospholipid antibodies: A systematic review and meta-analysis. J Gynecol Obstet Hum Reprod. 50(8):102121.  
  • Ye S, et al. 2023. The use of hydroxychloroquine in pregnancy and its effect on perinatal outcomes in a population with autoimmune abnormalities. Clin Rheumatol. 42(4):1137-1150.  
  • Zhu Q, et al. 2024. Effect of hydroxychloroquine on pregnancy outcome in patients with SLE: a systematic review and meta-analysis. Lupus Sci Med. 11(2):e001239. 

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