A systematic review and meta-analysis on the effects of statins on pregnancy outcomes

Abstract

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Clinical Evaluation of a Novel Tablet Formulation of Traditional Thai Polyherbal Medicine Named Nawametho in Comparison with Its Decoction in the Treatment of Hyperlipidemia

“…However, patient' responses to TLC varied, and poor adherence to this therapeutic protocol was cited as one of its drawbacks [11,12]. Furthermore, the administration of statins in patients with elevated serum LDL-C is the first-line pharmacological treatment and effectively reduces total cholesterol (TC) and LDL-C levels [13][14][15]. However, some adverse events such as muscle-related symptoms, increased liver enzyme transaminase, elevated blood glucose, and glycated hemoglobin levels have been reported [14,[16][17][18].…”

The Effect of Pravastatin on Hypoxia Inducible Factor-1-Alpha (HIF-1-A) Expression on the Placenta of Preeclampsia Wistar Rats

“…However, pravastatin is also believed to have pleiotropic effects as anti-inflammatory, anti-oxidant, anti-thrombotic, pro-angiogenic, and protective of the endothelium. 16 This study aims as one of the initial studies to explore the potential of pravastatin against functional abnormalities or placental hypoxia through in vivo HIF-1-A expression.…”

Update on Statin Use in Pregnancy

“…This was endorsed worldwide, including in recent statements by the National Lipid Association and the International Familial hypercholesterolemia Foundation [3,4]. However, more than three decades of experience with accidental statin use, immediately before and during pregnancy, did not corroborate these initial concerns [3,[5][6][7]. Further, recent well-performed large observational cohort studies have not substantiated any teratogenic effect of statins [8].…”

“…A Medicaid cohort study compared 1,152 statinexposed pregnant women to 886,996 matched controls but reported no teratogenic effects from maternal use of statins in the first trimester of pregnancy -after adjustment for potential confounders [15]. A recent meta-analysis of 9 observational studies found no association between statin use and stillbirth (OR 1.30; 95% CI 0.56-3.0; p=0.54), induced abortion (OR 2.08; 95% CI; 0.81-5.36; p=0.129), or elective abortion (OR 1.37; 95% CI, 0.68-2.76; p=0.378) [5] but spontaneous abortion was more common (OR 1.36; 95% CI, 1.10-1.68; p=0.004). More recently, a retrospective cohort study of 469 statin-exposed pregnant women (vs. 4,690 matched controls) reported no increase in congenital anomalies (RR, 1.24; 95% CI 0.81-1.90 after adjustment for maternal age and comorbidities), although there was a greater risk of low birth weight (RR 1.51; 95% CI, 1.05-2.16) and preterm birth (RR 1.99; 95% CI, 1.46-2.71) [16].…”

“…In conclusion, the FDA contraindication to statin use during pre-conception planning and pregnancy has been removed in light of considerable evidence pointing to the absence of excess teratogenic risk or other adverse pregnancy outcomes with inadvertent statin use [5,14,16]. Despite this change, the FDA still discourages the routine use of statins during pregnancy.…”