Pregnancy in women suffering from familial hypercholesterolemia: a harmful period for both mother and newborn?

Hans J. Avis, Barbara A. Hutten, Marcel Th B. Twickler, John J. P. Kastelein, Joris A. M. van der Post, Anton F. Stalenhoef, Maud N. Vissers

Research output: Contribution to journalReview articleAcademicpeer-review

41 Citations (Scopus)

Abstract

Purpose of review The present review aims to highlight the consequences for mother and child of profound hypercholesterolemia during pregnancy of women with familial hypercholesterolemia. Recent findings Familial hypercholesterolemia is increasingly diagnosed in younger patients due to the existence of screening programs and more widespread cholesterol testing. Increasing numbers of young female patients with familial hypercholesterolemia raise the issue of pregnancy and its consequences for the familial hypercholesterolemia patient herself but also for her offspring. When pregnancy is considered, lipid-lowering drugs are often discontinued because of the fear for teratogenic effects. The evidence for teratogenesis associated with statin use is scant and conflicting. On the other hand, several studies do suggest that pronounced hypercholesterolemia during pregnancy has adverse effects on both fetus and mother. In fact, human and animal studies reveal an enhanced tendency toward atherosclerosis in the offspring of women who suffer from hypercholesterolemia during pregnancy. In animal studies, some evidence exists that this can be reversed by treatment with lipid-lowering and antioxidative agents. Until today, however, no human studies exist that have evaluated efficacy or safety of lipid-lowering interventions in pregnant women with familial hypercholesterolemia. Summary Altogether, the suggested relationship between severe hypercholesterolemia and enhanced atherosclerosis in offspring and possibly the mother warrants further confirmation and, consequently, studies that focus on therapeutic strategies that can safely lower cholesterol levels during pregnancy in these women
Original languageEnglish
Pages (from-to)484-490
JournalCurrent opinion in lipidology
Volume20
Issue number6
DOIs
Publication statusPublished - 2009

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