Role of Hydroxychloroquine in Prevention of Congenital Heart Block in Pregnant Women With Positive Anti-Ro/SSA and/or Anti-La/SSB.

Neonatal lupus, a condition primarily affecting infants born to mothers with anti-Ro/SSA and/or anti-La/SSB antibodies, is linked to congenital heart block (CHB), a potentially life-threatening complication. Hydroxychloroquine (HCQ), an antimalarial with immunomodulatory properties, has been shown to reduce CHB recurrence. This review examines current evidence on HCQ's role in preventing CHB in pregnancies affected by those autoantibodies, focusing on overall, primary and secondary prevention. Evidence supports HCQ in overall and secondary prevention, but data on its effectiveness for primary prevention is lacking. Clinical guidelines, antibody titre thresholds, foetal heart rate monitoring and the need for randomised controlled trials are discussed.