Pravastatin for the prevention of preeclampsia in high-risk pregnant women

Maged Costantine, Kirsten Cleary

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Preeclampsia complicates approximately 3-5% of pregnancies and remains one of the major causes of maternal and neonatal morbidity. It shares pathogenic similarities with adult cardiovascular disease as well as many risk factors. Attempts at prevention of preeclampsia using various supplements and classes of medications have failed or had limited success, and they were not convincing enough to lead to widespread adoption of any particular strategy. Contrary to the experience with preeclampsia, prevention of cardiovascular mortality and other cardiovascular events in nonpregnant patients using 3-hydroxy-3-methyl- glutaryl-coenzyme A reductase inhibitors, or statins, is widely accepted. Pravastatin and other statins have been shown to reverse various pathophysiologic pathways associated with preeclampsia, such as angiogenic imbalance, endothelial injury, inflammation, and oxidative stress. These beneficial effects are likely to contribute substantially to preventing preeclampsia and provide biological plausibility for the use of pravastatin in this setting. Pravastatin has favorable safety and pharmacokinetic profiles. In addition, animal studies and human pregnancy exposure data do not support teratogenicity claims for pravastatin. Therefore, the Eunice Kennedy Shriver National Institute of Child Health and Human Development Obstetric-Fetal Pharmacology Research Units Network started a pilot trial to collect maternal-fetal safety data and to evaluate pravastatin pharmacokinetics when used as a prophylactic daily treatment in high-risk pregnant women (identifier NCT01717586, clinicaltrials.gov).

Original languageEnglish (US)
Pages (from-to)349-353
Number of pages5
JournalObstetrics and Gynecology
Volume121
Issue number2 PART 1
DOIs
StatePublished - Feb 2013

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Pravastatin
Pre-Eclampsia
Pregnant Women
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Fetal Research
Pharmacokinetics
National Institute of Child Health and Human Development (U.S.)
Mothers
Safety
Pregnancy
Obstetrics
Oxidoreductases
Oxidative Stress
Cardiovascular Diseases
Pharmacology
Inflammation
Morbidity
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Pravastatin for the prevention of preeclampsia in high-risk pregnant women. / Costantine, Maged; Cleary, Kirsten.

In: Obstetrics and Gynecology, Vol. 121, No. 2 PART 1, 02.2013, p. 349-353.

Research output: Contribution to journalArticle

Costantine, Maged ; Cleary, Kirsten. / Pravastatin for the prevention of preeclampsia in high-risk pregnant women. In: Obstetrics and Gynecology. 2013 ; Vol. 121, No. 2 PART 1. pp. 349-353.
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