Hydroxychloroquine
(Date: May 2020. Version: 1)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
What is it?
Hydroxychloroquine is a medicine used to treat malaria and autoimmune conditions such as lupus and rheumatoid arthritis. Hydroxychloroquine is also being used in clinical trials to treat coronavirus (COVID-19).
Is it safe to use hydroxychloroquine in pregnancy?
When deciding whether to use hydroxychloroquine during pregnancy, it is important to weigh up the potential benefits to your health and wellbeing against any possible risks to you or your baby, some of which may depend on how many weeks pregnant you are. Your doctor or specialist will be able to help you make decisions about your treatment.
What if I have already used hydroxychloroquine during pregnancy?
If you are taking any medicines while pregnant, you can discuss this with your doctor. You can then decide together whether ongoing treatment is appropriate, and if so, your doctor will ensure that you are taking the most effective dose.
Can using hydroxychloroquine in pregnancy cause birth defects in the baby?
A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.
There is no evidence that hydroxychloroquine causes birth defects, based on studies of around 750 women taking hydroxychloroquine in pregnancy. While this is reassuring, ongoing research is needed.
Can using hydroxychloroquine in pregnancy cause miscarriage?
Miscarriage appears to be about twice as likely in women using hydroxychloroquine compared to women not using hydroxychloroquine. However, it likely that this is due to underlying illnesses in mothers taking hydroxychloroquine (like lupus and malaria) rather than the medication itself.
Can using hydroxychloroquine in pregnancy cause stillbirth, preterm birth, or my baby to be small at birth (low birth weight)?
There is no evidence to suggest that stillbirth, preterm birth, or low birth weight are more common following treatment with hydroxychloroquine.
Can using hydroxychloroquine in pregnancy cause other problems in the baby/child?
Brain development continues throughout pregnancy. Medication taken at any stage of pregnancy could potentially affect a child’s learning or behaviour.
Exposure to hydroxychloroquine does not seem to affect childhood development, based on studies of approximately 250 children studied up to the age of three years. Further research, following up children to school age, is ideally required to support this finding.
Will my baby need extra monitoring?
As part of routine antenatal care, women will be offered a scan at around 20 weeks of pregnancy to look for any problems and to check the baby’s growth. Use of hydroxychloroquine in pregnancy does not require extra monitoring. Women with conditions that hydroxychloroquine is used to treat will be more closely monitored during pregnancy to ensure that they remain well and that their baby is growing and developing as expected.
Are there any risks to my baby if the father has taken hydroxychloroquine?
There is currently no evidence that hydroxychloroquine used by the father can harm the baby through effects on the sperm, and most experts agree that this is unlikely.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org