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Aeron Haworth
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Pregnant women or those hoping to start or extend a family should
avoid using the cholesterol-lowering drugs statins, say scientists.
Current
clinical guidelines already recommend that women who are pregnant
should stop taking statins but the advice is based on the knowledge
that cholesterol is essential for normal fetal development.
Indeed,
a 2007 study examining the risk of congenital anomalies in children of
pregnant women using statins suggested that the detrimental effects of
the drugs may be restricted to fat-soluble or 'lipophilic' statins only.
But
new research from The University of Manchester has shown that even
water-soluble or 'hydrophilic' statins, such as pravastatin, can affect
placental development leading to worse pregnancy outcomes.
"The
rapid rise in obesity and type-2 diabetes is a major health issue and
affected individuals are often treated with statins to lower
circulating cholesterol levels and reduce the risk of heart disease,"
said Dr Melissa Westwood, a Senior Lecturer in Endocrinology based at
the Maternal and Fetal Health Research Centre at St Mary's Hospital,
Manchester.
"Given the evolving demographic profile of these
conditions, such drugs are increasingly prescribed to women of
reproductive age but the actions of statins are not limited to the
regulation of cholesterol levels, as they can affect the production of
other chemicals in the body too.
"Our study examined the
effects that both lipophilic and hydrophilic statins had on a key
biological system that is crucial for maintaining the normal function
of the placenta, which acts as the nutrient-waste exchange barrier
between mother and fetus."
The research, funded by the
Biotechnology and Biological Sciences Research Council (BBSRC), used a
placental-tissue model that could be maintained in a viable state
outside the body for several days and tested the effects of two
different statins – one water-soluble and one that dissolves in fat.
As
expected, the fat-soluble statin, cerivastatin, affected the placenta
resulting in reduced growth but the researchers also found that
pravastatin – the water-soluble statin thought to be potentially
compatible for use in pregnancy – had the same detrimental effect.
"These
results clearly show that the effect of statins on the placenta is not
dependent on their lipophilicity as had previously been suggested,"
said Dr Westwood, whose findings are published in the Journal of Cellular and Molecular Medicine.
"While
hydrophilic statins have not been reported to increase the incidence of
fetal malformations, our research suggests that they will have a
detrimental effect on placental growth, which is likely to result in
poor pregnancy outcome.
"Healthcare professionals should
continue to advise women to avoid the use of any type of statin once
they plan to start a family or when a pregnancy is suspected or
confirmed."
Source: University of Manchester
Original article: Karen Forbes, Lucy M. Hurst, John D. Aplin, Melissa Westwood J. Martin Gibson. Statins are detrimental to human placental development and function; use of statins during early pregnancy is inadvisable. Journal of Cellular and Molecular Medicine 12:6a, 2295 - 2296, December 2009.
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