Hydroxychloroquine

Date: May 2020, Version 1

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.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.