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Risk of Ocular Anomalies in Children Exposed In Utero to Antimalarials: A Systematic Literature Review
Author(s) -
Gaffar Rouan,
Pineau Christian A.,
Bernatsky Sasha,
Scott Susan,
Vinet Évelyne
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23808
Subject(s) - medicine , offspring , in utero , hydroxychloroquine , pregnancy , pediatrics , dose , relative risk , cohort study , obstetrics , fetus , disease , confidence interval , genetics , covid-19 , infectious disease (medical specialty) , biology
Objective To determine whether offspring from mothers with systemic lupus erythematosus ( SLE ), exposed in utero to antimalarials, have an increased risk of ocular anomalies during childhood versus unexposed SLE offspring. Methods We systematically performed searches of PubMed, Embase, and Web of Science databases for original human data on fetal and/or child ocular outcomes following exposure to antimalarials during pregnancy and/or lactation, from their inception until March 2017. Results A total of 10 cohort studies and 2 randomized controlled trials, ranging in size from 6 to 444 exposed infants studied, and 3 case reports met the inclusion criteria for our systematic review. Collectively, 1,477 infants were studied, 789 of which were exposed to hydroxychloroquine or chloroquine. In all, 563 exposed infants had follow‐up visits after delivery (ranging from <3 months to 19 years), and 331 of these exposed infants underwent ophthalmologic examinations during the follow‐up period. Our review of the literature suggests a low‐to‐nonexistent risk of visual abnormalities in offspring exposed to antimalarials. Conclusion In children exposed to appropriate doses of antimalarials antenatally, the risk of ocular toxicity appears low to nonexistent. The potential benefits and risks of antimalarials should be discussed in all SLE pregnancies, and high dosages should continue to be avoided.