Pravastatin in preeclampsia: A meta-analysis and systematic review

Abstract

ObjectiveTo review of the efficacy and safety of pravastatin use for prophylaxis and treatment of preeclampsia.DesignSystematic review and meta-analysis of clinical studies evaluating pravastatin for treatment and/or prophylaxis of preeclampsia.Data collectionTwo independent reviewers systematically searched data from PubMed, Scopus, Web of Science, Cochrane, Embase, and clinicaltrials.gov databases, for studies evaluating pravastatin for prevention of pre-eclampsia.ResultsFourteen studies were identified, including 1,570 pregnant women who received either pravastatin or placebo, published between 2003 and 2022. From these studies, 5 studies were identified for inclusion in the meta-analysis to evaluate the role of pravastatin use prior to 20 weeks of gestation, to prevent pre-eclampsia, Pravastatin treatment reduced the incidence of preeclampsia by 61% and premature birth by 45%. Among the newborns, there was a 45% reduction in intrauterine growth retardation (IUGR) in the treated group, as well as a 77% reduction in those receiving neonatal intensive care unit (NICU) admissions.ConclusionProphylactic treatment with pravastatin appears to reduce risk of developing pre-eclampsia as well as potentially lowering risk of IUGR, preterm birth, and NICU admission in neonates.

Sex-Based Utilization of Guideline Recommended Statin Therapy and Cardiovascular Disease Outcomes: A Primary Prevention Healthcare Network Registry

“…30 Further, certain statins have been tested to treat hypertensive disorders during pregnancy. 31 In addition, women have tended to report more adverse effects ascribed to statin. 24,32 Prior studies have hypothesized this could be due to differential exposure to public warnings affecting patients’ perceptions as well as possible drug-drug interactions.…”

A meta-analysis on first-trimester blood count parameters—is the neutrophil-to-lymphocyte ratio a potentially novel method for first-trimester preeclampsia screening?

“…Our research group’s earlier meta-analysis highlighted that pravastatin therapy started before the 20th gestational week reduces preeclampsia development. The therapy is also beneficial for neonates, as it reduces the number of neonates born with IUGR, neonatal admissions to intensive care units, and the occurrence of preterm deliveries ( 102 ).…”

Understanding the Pathophysiology of Preeclampsia: Exploring the Role of Antiphospholipid Antibodies and Future Directions

“…Additionally, limited drug concentrations were observed in the umbilical cord, supporting the notion of restricted transplacental transfer of pravastatin. Lefkou et al demonstrated that in women with antiphospholipid syndrome and preeclampsia or intrauterine growth restriction (IUGR), the administration of 20 mg of pravastatin led to improved pregnancy outcomes and fetal health [59][60][61]. Furthermore, the efficacy of high-dose intravenous immunoglobulin therapy for pregnant women with aspirin-heparin-resistant secondary antiphospholipid syndrome was also evaluated [62].…”