Background: Current treatment does not prevent all maternal, foetal and neonatal complications of antiphospholipid syndorme (APS), with an overall frequency of failure despite modern treatment ranges from 20 to 30%

Objectives: To assess the pregnancy outcome in women with antiphospholipid antibody (aPL) treated with hydroxychloroquine (HCQ) during pregnancy

Methods: This observational, retrospective, single centre clinical study included 170 pregnancies in 96 women with persistent aPL. Sixty-five consecutive pregnancies occurred in 31 women treated with HCQ for at least 6 months prior to pregnancy. HCQ was continued throughout gestation (group A). One-hundred nineteen consecutive pregnancies occurred in 65 women with aPL who had not been treated with HCQ prior to conception acted as controls (group B).

Results: HCQ treatment was associated with a significantly higher rate of live births (66.7% in group A vs. 57.1% in group B, p=0.05) and a lower rate of pregnancy morbidity (47.1% in group A vs. 63.0% in group B, p=0.004). We observed a higher prevalence of spontaneous vaginal labour in HCQ-treated women compared to group B (37.3% vs. 14.3%, p=0.01). Pregnancy duration was longer in group A than B (27.6 [6-40] weeks vs. 21.5 [6-40], p=0.03). Fetal losses beyond 10 weeks gestation were less frequent in group A than B (2% vs 10.9%, p=0.05). Placenta mediated complications (pre-ecplampsia, abruption placenta and intrauterine growth restriction (IUGR)) were less prevalent in HCQ treated women compared to controls (2% vs. 10.9%, p=0.05).The association of HCQ with the absence of any complications in pregnancy was confirmed after multivariate analysis (OR 2.2; 95%CI [1.2-136.1]; p=0.04).

Conclusions: Women with aPL may benefit of treatment with HCQ during pregnancy. The addition of HCQ to conventional treatment is worthy of further assessment.

Disclosure of Interest: None declared

DOI: 10.1136/annrheumdis-2015-eular.6127