Antimalarial drugs and pregnancy.

The use of chloroquine and hydroxychloroquine during pregnancy is controversial. These 4-aminoquinoline drugs cross the placenta and have been reported to cause fetal abnormalities, including loss of vision, ototoxicity, and cochleovestibular dysfunction. However, other reports suggest that 4-aminoquinoline drugs can be taken safely during pregnancy, even in dosages used to control systemic connective tissue diseases. We retrospectively studied eight patients who took antimalarial drugs continuously throughout pregnancy. There was a total of 14 pregnancies in women receiving these drugs; three occurred during periods of disease activity and all of these resulted in failure to complete pregnancy successfully. Of the remaining 11 pregnancies exposed to antimalarial drugs, one resulted in stillbirth; four resulted in spontaneous abortion; and six had normal full-term standard deliveries. None of the live births demonstrated any congenital abnormalities. Hence, it is possible for women to produce normal live babies despite taking large doses of these drugs. If patients with systemic lupus erythematosus are already taking antimalarial drugs when they become pregnant, it is believed that the risk of disease flare and loss of pregnancy from discontinuing therapy outweighs any risks to fetuses from continuing the medication.