Risk of adverse pregnancy outcomes and impact of statin use in pregnant women with familial hypercholesterolemia

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2025-07-10 DOI:10.1016/j.atherosclerosis.2025.120442

Karianne Svendsen , Jacob Juel Christensen , Jannicke Igland , Henriette Walaas Krogh , Liv J. Mundal , David R. Jacobs Jr. , Martin P. Bogsrud , Kirsten B. Holven , Kjetil Retterstøl

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Abstract

Background and aims

Sparse data exist on the risk of adverse pregnancy outcomes in women with familial hypercholesterolemia (FH). We investigated associations between FH and adverse pregnancy outcomes, and between statin exposure in pregnancy and adverse pregnancy outcomes among women with FH.

Methods

We studied 3869 pregnancies among 1869 women with genetically-proven FH and 68225 pregnancies among 33661 women from the general population. Data on adverse pregnancy outcomes were obtained during 1967–2018 from the Medical Birth Registry of Norway. Data on pharmacy-dispensed statins were obtained from the Norwegian prescription database (2004–2018) in 1051 women with FH. Associations were presented as odds ratio (OR) with 95 % CI from logistic regression adjusted for mother's age, parity, and offspring's birth year.

Results

Women with FH had a higher risk of preeclampsia (OR 1.21 [1.00–1.46]), but lower risk for gestational diabetes (OR 0.58 [0.36–0.92]) and intrapartum hemorrhage during delivery (OR 0.81 [0.71–0.92]) compared to controls. No excess risk of adverse pregnancy outcomes in offspring was observed for FH. Among women with FH, statin exposure (mainly in the first trimester) may be associated with higher risk of low birth weight in offspring born at term (OR 2.42 [0.51, 11.45]).

Conclusions

Women with FH had lower risk of gestational diabetes and intrapartum hemorrhage, but a higher risk of preeclampsia compared to controls. No adverse birth outcomes were observed for offspring of mothers with FH, but the association between statin exposure in pregnant women with FH and low birth weight in offspring warrants further study.

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家族性高胆固醇血症孕妇使用他汀类药物的不良妊娠结局风险及影响

背景和目的关于家族性高胆固醇血症（FH）妇女不良妊娠结局风险的数据很少。我们调查了FH与不良妊娠结局之间的关系，以及FH妇女妊娠期间他汀类药物暴露与不良妊娠结局之间的关系。方法研究了1869例遗传证实的FH妇女中的3869例妊娠和33661例普通人群中的68225例妊娠。从挪威医疗出生登记处获得了1967-2018年期间不良妊娠结局的数据。从挪威处方数据库（2004-2018）中获得1051名FH妇女的药房配药他汀类药物数据。关联以比值比（OR）表示，95% CI来自经母亲年龄、胎次和后代出生年份校正的logistic回归。结果与对照组相比，FH患者发生子痫前期的风险较高（OR为1.21[1.00-1.46]），但发生妊娠期糖尿病的风险较低（OR为0.58[0.36-0.92]），分娩时产时出血的风险较低（OR为0.81[0.71-0.92]）。FH未观察到后代不良妊娠结局的额外风险。在FH妇女中，他汀类药物暴露（主要在妊娠早期）可能与足月出生的后代低出生体重的高风险相关（OR 2.42[0.51, 11.45]）。结论FH患者发生妊娠期糖尿病和产时出血的风险较低，但发生子痫前期的风险高于对照组。没有观察到患有FH母亲的后代有不良的出生结果，但患有FH的孕妇服用他汀类药物与后代低出生体重之间的关系值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.