Effects of Hydroxychloroquine on Maternal and Fetal Outcomes in Pregnant Patients with Lupus: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: The effects of hydroxychloroquine (HCQ) on maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE) have not been fully elucidated in recent research. This study aimed to provide a more comprehensive evaluation of the efficacy and safety of HCQ in pregnant patients with SLE. Methods: A systematic search of relevant articles was conducted using Medline, Embase, Scopus, Web of Science, and the Cochrane Library from inception to October 4th, 2023. The risk of bias in the included studies was assessed using the Newcastle-Ottawa Scale or Cochrane's Quality Assessment Form. Data on maternal and fetal outcomes of the HCQ treatment groups (HCQ+) and control groups (HCQ–) were extracted, analyzed and evaluated. Pooled odds ratios (ORs), pooled relative risks (RRs), and weighted mean differences with 95% confidence intervals (95% CIs) were calculated for the meta-analysis using Stata/MP V.18. Results: This meta-analysis included 17 studies, involving a total of 2238 pregnant patients with SLE. Compared to the HCQ– groups, the HCQ+ groups exhibited a significant reduction in the incidence of preeclampsia (RR = 0.51, 95% CI: 0.37–0.71), high lupus activity (RR = 0.77, 95% CI: 0.64–0.92), gestational hypertension (OR = 0.41, 95% CI: 0.18–0.91), premature delivery (RR = 0.71, 95% CI: 0.60–0.84), and fetal growth restriction (OR = 0.61, 95% CI: 0.43–0.85). Additionally, the HCQ+ groups exhibited a significant increase in fetal birth weight of 0.21 kg (95% CI: 0.09–0.33). No significant differences were revealed in the other 15 pregnancy outcomes between the two groups. Conclusions: Despite the presence of a certain heterogeneity among the included studies, this study provides a more comprehensive evaluation of the efficacy and safety of HCQ in pregnant patients with SLE.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.014 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".