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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Preconception Counseling for Women with Diabetes and Hypertension
Sponsored by The Indian Health Service Clinical Support Center
Step 8. Statins
The HMG-CoA reductase inhibitors (“statins”)
are officially contraindicated in pregnancy, however the evidence for their being teratogens is weak. Theoretical concerns about the role of cholesterol in embryonic development have prompted them being given the status of a “class X” drug. Animal studies however have not demonstrated that they are associated with malformations or fetopathic effects, except at maternally toxic doses.
Human studies are mostly uncontrolled case reports, not epidemiological studies, but even these limited data do not suggest that the statins are important human teratogens. Women exposed to these drugs in early pregnancy can therefore reasonably be reassured that their fetuses are not at increased risk. If a patient is inadvertently exposed during pregnancy, however, termination does not appear to be medically indicated.
A more important long term question is whether treating hyperlipidemia is clinically indicated during pregnancy to avoid long term sequale. Further study is needed, especially as more women of advanced age pursue pregancy options.
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