Lupus & antiphospholipid syndrome
Immunosuppressant use and adverse pregnancy outcomes in women with systemic lupus erythematosus: a retrospective cohort study in Korea
Authors' conclusion
Continuity of hydroxychloroquine use from preconception through pregnancy reduces preterm birth risk in SLE. Conversely, early exposure to teratogenic immunosuppressants heightens the risk of spontaneous abortion.
Study context
- Population
- Pregnancies in women with Systemic Lupus Erythematosus (SLE), National Health Information Database, Korea, 2005–2018pregnancies in 3,059 women
- Participants
- 4,880 pregnancies
- Exposure
- HCQ use patterns and teratogenic immunosuppressant exposure vs continuous HCQ use / no exposure
- Outcome
- Incidence of APO (preeclampsia/eclampsia, preterm birth, spontaneous abortion, stillbirth)
Methodological detailsnationwide claims database (NHIS Korea, 2005-2018), univariate and multivariable models
- Nationwide claims database (NHIS Korea, 2005-2018)
- Univariate and multivariable models
Main finding
As reported in the abstract
Overall APO incidence
Overall adverse pregnancy outcomes (APO) incidence among pregnant women with SLE
45.0%
95% CI 43.4, 46.5%
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Preterm birth by HCQ use patternHCQ non-usevs Continuous HCQ | 1.39 (1.05–1.85) | |
| Preterm birth by HCQ use patternHCQ discontinuationvs Continuous HCQ | 2.18 (1.61–2.95) | |
| Preterm birth by HCQ use patternHCQ initiation during pregnancyvs Continuous HCQ | 2.17 (1.16–4.06) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Spontaneous abortion by teratogenic immunosuppressant exposure
| aOR | |
|---|---|
| Teratogenic exposure within 3 months of preconception | 2.59 |
| Teratogenic exposure in first trimester | 3.18 |
Original publication
Immunosuppressant use and adverse pregnancy outcomes in women with systemic lupus erythematosus: a retrospective cohort study in Korea. Rheumatology (Oxford). Published 12 December 2025. doi:10.
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