Statins in Pregnancy: Can We Justify Early Treatment of Reproductive Aged Women?

Curr Atheroscler Rep. 2022 Aug;24(8):663-670. doi: 10.1007/s11883-022-01039-1. Epub 2022 Jun 14.

Abstract

Purpose of review: Statins are the pillar of secondary prevention in reducing cardiovascular disease in high-risk adults. However, statin discontinuation is the standard recommendation in pregnant and lactating patients. This review evaluates whether we can justify the early treatment of reproductive aged women with statin therapy.

Recent findings: Statins have several potential benefits including its antioxidant, anti-inflammatory, and anti-thrombogenic properties that may prevent the worsening of atherosclerosis in high-risk women. Nevertheless, most studies on statins and teratogenicity have a limited sample size and the effects of long-term statin use on fetal and neonatal health remain unknown. Not all statins may be safe and pravastatin's cholesterol-lowering properties may be too limited to provide much maternal benefit in pregnancy. While emerging evidence supports the use of pravastatin in pregnancy, we need to better assess the risk of early cardiovascular disease and acute progression of atherosclerosis before and during pregnancy to better understand the risks and benefits of statin use.

Keywords: Atherosclerosis; Cardiovascular disease; Dyslipidemia; Pravastatin; Pregnancy; Statin therapy.

Publication types

  • Review

MeSH terms

  • Adult
  • Atherosclerosis* / drug therapy
  • Cardiovascular Diseases* / prevention & control
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Infant, Newborn
  • Lactation
  • Pravastatin / therapeutic use
  • Pregnancy

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pravastatin