Covid-19 and pregnancy

Hydroxychloroquine early in pregnancy and risk of birth defects

Am J Obstet Gynecol Sep 2020

Much has been written about the unproven efficacy of hydroxychloroquine and covid-19. This article reports a a population-based cohort study that included 2045 hydroxychloroquine-exposed pregnancies ascertained from insurance program data collected from 3 months before LMP to 1 month after delivery. The cohort was limited to women using hydroxychloroquine during the first trimester of pregnancy and women with rheumatic disorders. They found an adjusted relative risk of 1.33 (1.08-1.65) for a daily dose of ≥400 mg and 0.95 (0.60-1.50) for a daily dose of <400 mg for major congenital malformation with no pattern of malformation. While the risk-benefit analysis is positive for most patients with autoimmune rheumatic disorders, the benefits of treatment during pregnancy for coronavirus disease 2019 prophylaxis would need to be balanced against such benefits.