Hydroxychloroquine Therapy in Women with Autoimmune Recurrent Pregnancy Loss Refractory to Low Dose Aspirin and Heparin: A Randomized Controlled Trial

Abstract

ydroxychloroquine (HCQ) is a novel medication for people suffering from autoimmune-related recurrent pregnancy loss. Many autoimmune disorders have been related to poor obstetric outcomes, anti-phospholipid syndrome (APS) is the only immune disorder in which pregnancy loss is a diagnostic requirement. The goal of this study is to see how beneficial it is to provide hydroxychloroquine (HCQ) in addition to low-molecular-weight heparin (LMWH) and low-dose aspirin (LDA) to females having a record of autoimmune-related recurrent pregnancy loss and refractoriness to low-dose aspirin and LMWH solely in previous pregnancies, both preconception and during pregnancy. Between January 2019 and January 2021, 120 females with a record of autoimmune recurrent pregnancy loss at Ain Shams University Maternity Hospital. Participants were divided into two classes using computer based randomization procedures. Preconception and during pregnancy, group A (60 cases) received hydroxychloroquine (HCQ), while group B (60 cases) received a placebo. Also, they received LDA and LMWH. The primary outcome measure in this study was the rate of live births. Secondary outcomes included gestational age at delivery, birth weight, mode of delivery, , Apgar score 5 minutes, neonatal morbidity, rate of neonatal intensive care unit (NICU) admission, and post-natal mortality rate.