In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure to hydroxychloroquine may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your healthcare providers.

What is hydroxychloroquine?

Hydroxychloroquine is a medication used to prevent and treat malaria and to treat autoimmune conditions such as rheumatoid arthritis or lupus. Hydroxychloroquine is sold under several brand names, including Plaquenil®.

For more information on rheumatoid arthritis or lupus in pregnancy please see the MotherToBaby fact sheet on those topics at: https://mothertobaby.wpengine.com/fact-sheets/rheumatoid-arthritis/pdf or https://mothertobaby.wpengine.com/fact-sheets/lupus-pregnancy/pdf/. For information on malaria, please see the MotherToBaby fact sheet at: https://mothertobaby.wpengine.com/fact-sheets/malaria/pdf/.

How long does hydroxychloroquine stay in the body? Should I stop taking it before I try to get pregnant?

Individuals break down medicines at different rates. On average it would take over 8 months for all the hydroxychloroquine to be gone from a person’s body. Some women may choose to stop taking this medication before becoming pregnant; however, it’s important not to stop any medications before talking with a health care provider. It is important to think about the benefits of taking hydroxychloroquine and treating your condition during pregnancy versus the possible risks of stopping the medication and having more symptoms and uncontrolled disease during pregnancy.

Can taking hydroxychloroquine make it more difficult for me to become pregnant?

Hydroxychloroquine has not been studied to see if it could make it harder to get pregnant while taking this medication.

Can taking hydroxychloroquine make it more likely for me to have a miscarriage?

Several studies have not found a higher chance of miscarriage related directly to hydroxychloroquine. In one study, a higher chance was reported; however, the mother’s disease may have contributed to the higher risk according to the authors. Malaria and autoimmune conditions like lupus can increase the chance of miscarriage.

Can taking hydroxychloroquine during my pregnancy cause birth defects?

Studies have looked at over 400 pregnancies and have not found an increased chance for birth defects with hydroxychloroquine use for the treatment of rheumatic diseases.

Can taking hydroxychloroquine cause other problems for the baby?

Studies do not suggest that hydroxychloroquine directly increases the chance for premature delivery (delivery before 37 weeks of pregnancy). Malaria and Lupus may increase the chance for premature delivery.

An uncommon side effect of this medicine is damage to the inner lining of the eye (called retinopathy). This has raised concern for vision problems in children whose mothers have taken hydroxychloroquine during pregnancy. However, most studies on young children whose mothers took hydroxychloroquine have not found an increase in eye problems.

Could taking hydroxychloroquine help prevent pregnancy complications?

Hydroxychloroquine may benefit pregnancies by reducing active disease of lupus. Hydroxychloroquine may also reduce the chance for a baby to be born with a specific heart conduction problem, called congenital heart block. More studies are needed to understand if hydroxychloroquine helps prevent pregnancy complications.

Can I take hydroxychloroquine while breastfeeding?

Small amounts of hydroxychloroquine have been found to enter breast milk. Small studies have reported no harmful effects in infants whose mothers’ breastfed while taking hydroxychloroquine. This includes no evidence of vision, hearing, or growth problems in young children who were followed up to about one year of age. Be sure to talk to your health care provider about all breastfeeding concerns.

What if the father of the baby takes hydroxychloroquine?

There are no studies looking at possible risks to a pregnancy when the father takes hydroxychloroquine. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at https://mothertobaby.wpengine.com/fact-sheets/paternal-exposures-pregnancy/pdf/.

MotherToBaby is currently conducting a study looking at autoimmune diseases and the medications used to treat autoimmune diseases in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or visit https://mothertobaby.wpengine.com/join-study/.

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