Statin Therapy May Prevent Premature Births

Researchers have found that a novel statin therapy could reduce the likelihood of women with antiphospholipid syndrome (APS) delivering a premature baby.

The treatment was also seen to increase survival in the babies and improve maternal health, according to a study published by the Journal of Clinical Investigation.

“Many pregnant women with antiphospholipid syndrome do not respond to conventional antithrombotic treatment and face serious complications, such as preeclampsia and severe intrauterine growth restriction, threatening their lives and their babies' lives,” said senior author Guillermina Girardi, PhD. “We found that a drug which has been widely used in the general population to prevent cardiovascular disease appears to help prevent pregnancy complications in women with antiphospholipid syndrome.”

APS is an autoimmune disorder where the body creates antiphospholipid antibodies that attack phospholipids in the cell membrane. APS can also increase the risk of preeclampsia in pregnancy caused by an abnormal formation of the placenta.

It increases blood pressure and causes proteinuria, which can be fatal for both the mother and fetus. APS also increases the risk of intrauterine growth restriction (IUGR).

Antiphospholipid antibodies can affect how the placenta develops and can reduce blood flow. This can cause diminished fetal growth, and lead to premature birth due to fetal distress.

The standard anticlotting treatment of aspirin and heparin has not been found to improve outcomes for pregnancies, according to the study. The researchers treated 11 women with pravastatin, a statin that does not reach the fetus along with the standard treatment.

They also included 10 women who only received the standard treatment. Pravastatin was previously shown to prevent adverse outcomes in pregnant mice models of APD and preeclampsia, according to the study.

In the group that received pravastatin, all babies were born alive, compared with the standard care group where only 7 survived after birth. Researchers found that pravastatin lowered blood pressure and proteinuria.

They also found that these patients had increased blood flow to the placenta and stopped IUGR, which reduced premature births. Researchers found that 8 babies were delivered at 36 weeks or later.

Emergency caesarian sections were performed 7 out of 10 times due to fetal distress or maternal health concerns. The median time of birth was at 26 weeks.

In the standard care group, premature babies spent longer in the neonatal intensive care unit. Researchers found that 3 of these babies had poor health outcomes, such as neurological and gastrointestinal complications.

“Pravastatin helped to increase blood flow through the placenta, keeping the baby growing and reducing the symptoms of preeclampsia in the mothers. In the group supplemented by pravastatin, the babies were born alive, healthy, close to full term and showed normal development. In contrast, the group that received only anti-clotting drugs experienced a higher rate of stillbirths and premature births requiring admission to the neonatal intensive care unit,” concluded Dr Girardi. “Our study was a small case series that was not randomized and historic controls were used for comparison, so larger randomized clinical trials are needed to fully establish the safety and effectiveness of this treatment before it can be recommended for clinical use. The potential benefits of statin treatment for women who develop preeclampsia without APS are also worth investigating.”