Letter to the Editor
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Sep 20, 2023; 13(4): 99-101
Published online Sep 20, 2023. doi: 10.5493/wjem.v13.i4.99
Update on hydroxychloroquine use in pregnancy
Wassan Nori, Nabeeha Najatee Akram, Raid M Al-Ani
Wassan Nori, Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad 10052, Iraq
Nabeeha Najatee Akram, Department of Pediatrics, Mustansiriyah University, Baghdad 10052, Iraq
Raid M Al-Ani, Department of Surgery/Otolaryngology, University of Anbar, Anbar 31001, Iraq
Author contributions: Nori W and Akram NN designed research and analyzed data; Nori W wrote the letter; Akram NN and Al-Ani RM revised the letter; All authors have read and agreed on the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wassan Nori, PhD, Academic Editor, Academic Research, Senior Researcher, Department of Obstetrics and Gynecology, Mustansiriyah University, No. 58 Al-amin Street, Baghdad 10052, Iraq. dr.wassan76@uomustansiriyah.edu.iq
Received: April 13, 2023
Peer-review started: April 13, 2023
First decision: July 4, 2023
Revised: July 5, 2023
Accepted: July 24, 2023
Article in press: July 24, 2023
Published online: September 20, 2023
Abstract

It is well-known that hydroxychloroquine (HCQ) treats malaria, systemic lupus erythematosus, and rheumatoid arthritis in women for its immunomodulatory and anti-inflammatory action. Additionally, HCQ was used in cases with refractory antiphospholipid syndrome. HCQ safety was reinforced in pregnant women owing to insignificant reports of adverse pregnancy outcomes and major congenital malformation. Recently, HCQ was tested in cases with chronic placental inflammation with a promising result of increased life birth; however, its benefit needs further validation. We aimed to highlight the recent updates for HCQ use in various conditions in pregnancy.

Keywords: Pregnancy, Hydroxychloroquine, Preeclampsia, Antiphospholipid syndrome, Chronic placental inflammation, COVID-19

Core Tip: The immunomodulatory, anti-inflammatory, and anti-thrombotic activity of hydroxychloroquine (HCQ), an anti-malarial drug, made it recommendable for rheumatoid arthritis and systemic lupus erythematosus. HCQ was also implemented in refractory antiphospholipid syndrome showing a successful outcome. Recent evidence supports the benefits of its use to outweigh the risk during pregnancy as it reduces the disease activity and the associated adverse pregnancy outcome. Chronic placental inflammation is another condition for which HCQ proved to be helpful. Further investigations are required to verify HCQ’s efficacy in chronic placental inflammation as well as its action in reducing the severity of coronavirus disease 2019 in pregnant women.