By now most folks are aware that the class of drugs called statins can lower levels of blood cholesterol by their action on the liver and thus help prevent heart attacks. But they may be able to do more than that. In addition to their effectiveness lowering cholesterol, statins have anti-inflammatory effects. And a small, new, study demonstrated the efficacy of one statin in preventing the negative consequences of antiphospholipid syndrome (APS) for pregnant women and their offspring.
APS is an autoimmune disease in which the body produces antibodies against phospholipids — molecules that are an integral part of cell membranes. If a woman with APS becomes pregnant both she and her baby have an increased risk of negative consequences. The mother may develop preeclampsia (PE) — possibly life-threatening for both mother and baby; and the infant will be more likely to be growth-retarded and premature.
The typical treatment for such women has been anti-clotting treatments such as low-dose aspirin and heparin, which don't protect against some of APS's negative effects. However, animal studies have suggested that statins could be useful in preventing complications of APS during pregnancy.
Dr. Guillermina Girardi from King's College, London, UK, and colleagues from Aristotle University of Thessaloniki, Thessaloniki, Greece, tested the efficacy of pravastatin in a small study of 21 pregnant women with APS who developed PE or whose babies developed growth retardation. Ten women received the standard anti-clotting therapy (the control group); the other eleven received that therapy plus pravastatin.
In the control group, only six of the eleven babies were born alive, and 3 of these showed signs of abnormal development. But in the group treated with pravastatin, all 10 infants survived, and deliveries occurred at or close to term.
Doppler imaging demonstrated enhanced blood flow in the placentas of the women treated with pravastatin and the authors suggested: "The rapid response to pravastatin observed in uterine artery hemodynamic parameters suggests that pravastatin might be targeting placental vasculopathy in APS patients who develop PE."
Although the prevalence of APS itself is not high, pre-eclampsia is a not unusual complication of pregnancy. Indeed, "Ten million women develop pre-eclampsia each year worldwide; from these instances, approximately 76,000 pregnant women and 500,000 babies die" the authors stated. Thus the implications of the present study bode well for women with or without APS.
While this small study is obviously preliminary, further research and independent replication may well establish statins as an effective tool to control PE and prevent its negative consequences for both mother and baby.