Pregnancy outcomes in FH do not differ from the general population
MedWire News: Genetically determined elevated low-density lipoprotein (LDL) cholesterol does not adversely affect pregnancy outcome, say Norwegian researchers.
The team found that women with familial hypercholesterolemia (FH) do not have an increased risk for prematurity (birth < gestational week 37), low birth weight (<2500 g), or frequency of congenital malformations compared with women in general.
"The results from the present study may thus be reassuring for FH women in childbearing age and their obstetricians," remark Per Ole Iversen and colleagues from the University of Oslo.
Women with FH are prone to early cardiovascular disease and death, explain Iversen and team. However, it is unknown whether FH adversely affects pregnant women and their birth outcomes in clinical terms.
To investigate, the researchers analyzed data from 1869 FH women (aged ≥14 years) from the Medical Genetics Laboratory and about 2 million (general population) from the Medical Birth Registry of Norway during 1967 through 2006.
As reported in the journal Circulation, the frequency of preterm delivery, low birth weight, and congenital malformations were statistically similar to those in the general population (6.8%, 5.0%, and 3.3% versus 6.2%, 5.2%, and 3.2%, respectively).
Interestingly, note Iversen et al, FH women gave birth to more normal-weight infants and fewer high-weight infants compared with women in the general population.
"The explanation for this is unclear," they say, "but may indicate a better nutritional status of FH women, because low maternal weight gain is associated with an increased incidence of both low- and high-birth weight infants."
No significant increases in risk for prematurity were detected when the team compared pregnancies before and after the introduction of statin therapy.
However, in an accompanying editorial, John Rutherford (UT Southwestern Medical Center, Dallas, Texas, USA) said that although high LDL cholesterol levels during childbearing years may have long-term implications for women with FH, statins "should be avoided in pregnancy."
He explained that because data about the safety of statins in human pregnancy are limited, "it would seem prudent to avoid using these drugs during pregnancy or lactation, and women of childbearing age should be counseled to stop taking these medications at least 1 month before discontinuing contraception."
But Iversen et al conclude that, on the basis of their results, "there is no particular reason to assume that the FH women differed from those of the general population apart from their lipid disorder."
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By Nikki Withers