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

Abstract

AbstractBackground and aimsSparse data exist on the possible risk of adverse pregnancy outcomes in women with familial hypercholesterolemia (FH). We investigated associations between having a FH diagnosis and adverse pregnancy outcomes, and between statin exposure in pregnancy and adverse pregnancy outcomes among women with FH.MethodsThis registry-based study included 3869 pregnancies among 1869 women with FH and 68225 pregnancies among 33661 women from the general population. Data on adverse pregnancy outcomes were obtained from the Medical Birth Registry of Norway with data from 1967-2018. 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.ResultsWomen 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 outcome in offspring was observed for FH vs controls. Women with FH using statins in pregnancy (n=260) had a higher risk of having offspring with low (<2500 g) birth weight (OR 2.20 [1.11, 4.49]) compared to non-exposed women with FH (n=791).ConclusionsWomen with FH had lower risk of gestational diabetes and intrapartum hemorrhage during delivery and non-significantly higher risk of preeclampsia compared to controls. No difference in adverse pregnancy outcomes in the offspring was observed. Statin exposure in pregnancy was associated with a higher risk of having offspring with low birth weight among women with FH, and this association warrants further investigations.