# Can hydroxychloroquine prevent preeclampsia and preterm delivery in lupus pregnancy?

> **NIH NIH R01** · STANFORD UNIVERSITY · 2024 · $328,505

## Abstract

This is a new application for an R01 award for epidemiologist Dr. Julia Simard, at Stanford 
University School of Medicine, who brings an innovative lens to the field as an early stage 
investigator building a research program focused on adverse pregnancy outcomes in patients 
with systemic lupus erythematosus. For her K01 award, Dr. Simard and colleagues showed that 
pregnant women with lupus are a highly-medicated group, who experience more adverse 
outcomes, including early-onset preeclampsia, preterm delivery, infection, and stroke. In recent 
pilot work, Dr. Simard found that hydroxychloroquine (HCQ), which is used to manage lupus 
during pregnancy, may prevent preeclampsia and preterm delivery. In two populations (one US 
and one in Sweden), Dr. Simard also found that fewer than half of pregnant women with lupus 
use HCQ, despite recommendations. This has been corroborated by others as well. 
Dr. Simard builds upon this work in the present application via three large international 
populations to determine whether HCQ reduces the risk of these adverse outcomes in lupus 
pregnancies. Dr. Simard will partner with colleagues in Sweden, Israel, and Kaiser Permanente 
of Northern California’s Division of Research in the United States. These data include details on 
ordered and filled prescriptions, and often unavailable data on antiphospholipid antibody status 
and parity, two critical factors in lupus reproductive research. In aim 1, Dr. Simard will determine 
whether preeclampsia risk is reduced in women who use HCQ during pregnancy. In aim 2, Dr. 
Simard will examine preterm delivery, partitioning spontaneous from medically-indicated, to 
examine overall risks and medication by preeclampsia and other factors such as glucocorticoid 
use and gestational diabetes. 
In aim 3, Dr. Simard’s team will identify barriers and facilitators of HCQ use in pregnant women 
with lupus using an innovative mixed methods design. After evaluating patient adherence and 
guideline adherence by clinicians in the large US and Israeli databases, they will identify 
subsets less likely to adhere and examine how they differ from adherent patients. Then 
partnering with patients and providers, they will use these quantitative findings to identify 
barriers and facilitators of adherence from the patient and provider perspectives using focus 
groups. This aim will provide key information on HCQ use and prescription practices to improve 
the analytic paradigm and inform our clinical understanding HCQ use in lupus pregnancy, and 
provide foundational support for clinical care and possibly, a future clinical trial.

## Key facts

- **NIH application ID:** 10889183
- **Project number:** 5R01AR077103-05
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Julia F Simard
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $328,505
- **Award type:** 5
- **Project period:** 2020-08-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10889183

## Citation

> US National Institutes of Health, RePORTER application 10889183, Can hydroxychloroquine prevent preeclampsia and preterm delivery in lupus pregnancy? (5R01AR077103-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10889183. Licensed CC0.

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