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Statins and Pregnancy

Between Supposed Risks and Theoretical Benefits

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Abstract

Cardiovascular diseases are the leading cause of mortality in industrialized countries. Treatment with statins is effective in primary prevention in patients at high cardiovascular risk. Statins are inhibitors of hydroxymethylglutarylcoenzyme A (HMG-CoA) reductase and are classed as lipid-lowering drugs. In 2010, atorvastatin was the biggest-selling drug in the world ($US10.73 billion). Increases in the average age of pregnant women and in the prevalence of morbid obesity have inevitably led to exposure to statins in certain women during the first trimester of pregnancy. The teratogenic risk attendant upon use of statins is unclear because the available data are contradictory, but statins remain contraindicated in pregnant women.

The benefits of statins in prevention of cardiovascular risk may not be solely due to their cholesterol-lowering effects: the so-called pleiotropic effects of vascular protection lead some experts to posit a potential benefit in the management of preeclampsia.

In this review we evaluate the theoretical benefits and supposed risks of statins in pregnant women. After a brief overview of the pharmacodynamic properties of statins, we address the question of the teratogenic risk of statins, and then detail the rationale for the therapeutic potential of statins in preeclampsia.

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Acknowledgements

No sources of funding were used to conduct this study or prepare this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Maternité Port-Royal, Cochin Hospital, AP-HP, Paris-Descartes University, 53 Av de l’Observatoire, 75014, Paris, France

    Edouard Lecarpentier &  Vassilis Tsatsaris

  2. Department of Obstetrics and Gynecology, Maternité Régionale Universitaire de Nancy, Nancy I H. Poincaré University, Nancy, France

    Olivier Morel

  3. INSERM U767, Paris-Descartes University, Paris, France

    Thierry Fournier &  Vassilis Tsatsaris

  4. Centre de Référence sur les Agents Tératogènes, Armand Trousseau Hospital, Paris, France

    Elisabeth Elefant

  5. INRA, UMR 1198 Biologie du Développement et Reproduction, Jouy en Josas, France

    Pascale Chavatte-Palmer

  6. Premup Foundation, Paris, France

    Pascale Chavatte-Palmer &  Vassilis Tsatsaris

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  1. Edouard Lecarpentier
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  2. Olivier Morel
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  3. Thierry Fournier
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  4. Elisabeth Elefant
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  5. Pascale Chavatte-Palmer
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  6. Vassilis Tsatsaris
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Correspondence to Vassilis Tsatsaris.

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Lecarpentier, E., Morel, O., Fournier, T. et al. Statins and Pregnancy. Drugs 72, 773–788 (2012). https://doi.org/10.2165/11632010-000000000-00000

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