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Survey of Antimalarial Use in Lupus Pregnancy and Lactation
ADEEBA AL-HERZ, MICHAEL SCHULZER, and JOHN M. ESDAILE
ABSTRACT.
Methods. Seventy-eight lupus experts identified from North America and UK were mailed a 19 question survey regarding their experience using AM in pregnancy and lactation. Results. The 52 (67%) respondents with usable questionnaires treated a median of 75 lupus patients/year, including 4-5 lupus pregnancies/year. Thirty-five (69%) continued AM sometimes, often, or always during pregnancy. Continuing AM increased with the number of pregnant lupus patients seen (p < 0.01). None reported having seen any fetal toxicity with AM use, and pregnancy was never terminated because of AM, other than at patient insistence (n = 1). Postpartum, 29 (63%) continued AM and advised breast-feeding. Responses were consistent among North American and UK experts. Conclusion. The majority of lupus experts continue AM during pregnancy. This was particularly true for those who treated a larger number of pregnant lupus patients per year. The majority advise breast-feeding and continue AM postpartum. These practices are supported by the limited literature available. (J Rheumatol 2002;29:700-6) Key Indexing Terms:
ANTIMALARIAL TREATMENT
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