Comment on: British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding

Dear Editor, In response to the new BSR guidelines on prescribing drugs in pregnancy and breastfeeding: ‘immunomodulatory anti-rheumatic drugs and corticosteroids’ and ‘comorbidity medications used in rheumatology practice’ [1, 2] we would like to add further data on the important topic of the rates of congenital abnormalities in pregnancies in women receiving HCQ. We audited our retrospective cohort of 521 pregnancies in women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS), which comprises all women referred to the aPL pregnancy clinic at St Thomas’ Hospital, London between January 2008 and December 2017 (audit number 7823). All consecutive women with persisting aPL were included in the analysis if complete pregnancy outcome data was available. Demographics, aPL profile, previous aPL-related history and antibody profile were collected. Our cohort was made up as follows: white, 186 (50%); Asian, 34 (9%); black, 17 (5%); other, 94 (25%); and not specified, 40 (11%). The median BMI was 26.7 (range 16–53), and our cohort’s BMIs reflected that of the British population.