The risks of statin use in pregnancy: A systematic review

Karalis, Dean G.; Hill, Alethea N.; Clifton, Shari; Wild, Robert A.

doi:10.1016/j.jacl.2016.07.002

Cited by 144 publications

(98 citation statements)

References 23 publications

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“…We also observed an ongoing use of antilipidemic agents, which are primarily indicated as preventive treatment for long‐term cardiovascular complications. The risks when used during pregnancy are poorly characterised . Guidelines suggest discontinuing use in pregnancy, as all antilipidemics are categorised as potentially teratogenic (category D).…”

Section: Discussionmentioning

confidence: 99%

Utilisation of teratogenic medicines before and during pregnancy in Australian women

Raichand

Pearson

Zoëga

et al. 2019

Aust NZ J Obst Gynaeco

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Background:Given the potential hazards of teratogenic medicines, to a fetus exposed in utero, monitoring their use around pregnancy is imperative. Aim: To measure utilisation of teratogenic medicines (Therapeutic GoodsAdministration's category D or X) in women who gave birth in New South Wales, Australia, during pregnancy and the 24 months prior. Materials and Methods:We used linked population-based datasets including dispensing and perinatal data for all deliveries in NSW between 2005 and 2012. We included pregnancies among concessional beneficiaries only, with complete ascertainment of dispensing claims. Pre-pregnancy and during-pregnancy periods were based on birth dates and gestational age. We determined prevalence of exposure using percent of pregnancies in which women had at least one dispensed teratogenic medicine in three-month time periods. Results:The study included 191 588 pregnancies (145 419 women). Prevalence of exposure to D/X medicines anytime during pregnancy was 2.0% (<20 pregnancies category X), decreasing from pre-pregnancy (3.8-6.0%) to first trimester (1.5%), further decreasing in second and third trimesters (0.8% and 0.6% respectively). We observed large reductions in antibiotic prevalence but only modest reductions for psychotropics and antilipidemic agents (all category D). Our results suggest higher use of potentially teratogenic medicines (category D) than those strictly contraindicated for use (category X), during pregnancy. Overall, use was higher in the first trimester than the rest of pregnancy. The high prevalence of potentially contraindicated psychotropics in all three trimesters may suggest a higher benefit-to-risk ratio and warrants future research focusing on the reasons for their prescribing to pregnant women.

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Section: Discussionmentioning

confidence: 99%

Utilisation of teratogenic medicines before and during pregnancy in Australian women

Raichand

Pearson

Zoëga

et al. 2019

Aust NZ J Obst Gynaeco

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“…A controlled trial in adults is ongoing 117 . Paediatric safety data for statins in large cohorts have been published only for children with familial hypercholesteremia [118][119][120][121] , and the risk of statin therapy in pregnancy is unclear 122 . We were therefore unable to reach a consensus on the use of statins to slow disease progression in children with ADPKD.…”

Section: Statinsmentioning

confidence: 99%

International consensus statement on the diagnosis and management of autosomal dominant polycystic kidney disease in children and young people

et al. 2019

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Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disease in adults, with an estimated prevalence of 1 in 500-2,500 (refs 1-4). Cyst development starts early in life, and macroscopic cysts can become detectable in childhood. Substantial disease burden with massively enlarged kidneys or decreased glomerular filtration rate (GFR) usually does not occur until adulthood 5 ; however, approximately 3% of children who carry ADPKD-causing mutations have either very-early-onset or unusually rapid progressive disease 5-7. Thus, the absolute incidence of symptomatic ADPKD in childhood is thought to be higher than that of other severe paediatric kidney diseases such as autosomal recessive polycystic kidney disease (~1 in 20,000), nephrotic syndrome (~1 in 50,000) 8 or haemolytic uraemic syndrome (~1 in 100,000 children) 9. The past 25 years have seen remarkable progress in knowledge of ADPKD. Advances have been made in unravelling the genetic origins of the disease, in noninvasive monitoring and in predicting disease progression; multiple large-scale clinical trials have been conducted; and the first pharmacological treatment for

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“…Their use during pregnancy is considered controversial, as they were formerly linked to a risk of congenital malformations in the first trimester, although recent studies have not confirmed these findings. The intake of statins by patients with hypercholesterolemia can typically be paused during pregnancy without substitution [36]. While statins were reported to reduce sFlt-1 in a preclinical setting, no final conclusion could be drawn in a clinical trial so far, due to the low case numbers.…”

Section: New Therapeutic Optionsmentioning

confidence: 99%

Hydroxychloroquine as a Preventive and Therapeutic Option in Preeclampsia – a Literature Review

Deharde

Klockenbusch

Schmitz

et al. 2020

Geburtshilfe Frauenheilkd

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Preeclampsia is one of the most feared complications of pregnancy and puerperium and represents a serious threat to mother and child. In addition, a history of preeclampsia increases the risk of future cardiovascular events. New diagnostic and therapeutic approaches are needed. New therapeutic options are currently being discussed, one of which is the administration of hydroxychloroquine. It is an antimalarial drug which is also used to treat rheumatological disease and its use in pregnancy is considered safe. A reduced incidence of preeclampsia in patients with selected rheumatological disorders after administration of hydroxychloroquine has already been shown; however, the case numbers are very low. Neither the full pathogenesis of preeclampsia nor the exact modes of action of hydroxychloroquine have been completely elucidated, but there are several common features which make hydroxychloroquine a promising option for the prevention and treatment of preeclampsia. Further research, especially prospective, randomized controlled trials, is needed to prove its efficacy. This review discusses the pathogenesis of preeclampsia and gives an overview of new options for its prevention and treatment, including the administration of hydroxychloroquine in pregnancy.

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The risks of statin use in pregnancy: A systematic review

Cited by 144 publications

References 23 publications

Utilisation of teratogenic medicines before and during pregnancy in Australian women

Utilisation of teratogenic medicines before and during pregnancy in Australian women

International consensus statement on the diagnosis and management of autosomal dominant polycystic kidney disease in children and young people

Hydroxychloroquine as a Preventive and Therapeutic Option in Preeclampsia – a Literature Review

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