Does atorvastatin treatment in a pregnant woman pose any risk to the fetus?/nA 31-year-old woman wi

Fråga: Does atorvastatin treatment in a pregnant woman pose any risk to the fetus?

A 31-year-old woman with obesity and hypercholesterolemia has been treated with atorvastatin 20 mg daily until week 6 (plus 4 days) of pregnancy.

Sammanfattning: There are no reports in the literature concerning atorvastatin use in pregnancy. Based on the limited experience in humans and some reported cases of malformations, HMG-CoA reductase inhibitors should not be used during pregnancy. However, the exposure to these drugs cannot be considered an indication for abortion. One case of atorvastatin treatment during early pregnancy, resulting in a healthy baby, is known to the Drug Research and Information Centre.

Svar: A similar question was answered in Drugline in august 1999. It was concluded that the use of HMG-CoA reductase inhibitors, like atorvastatin or simvastatin, should be avoided during pregnancy, based on animal data, limited human experience and some reported cases of malformations, but that the accidental use of these drugs during pregnancy could not be considered an indication for abortion (1).

No further information could be retrieved from the literature today. The Swedish Birth Register has not received any new reports concerning exposure to HMG-CoA reductase inhibitors in pregnancy. Present data include 12 pregnancies where the mother was exposed to either simvastatin (7 cases) or pravastatin (5 cases). One child in the simvastatin group was born with an unspecified cardiac defect. One child with an extra finger and one with retentio testis occurred among the pravastatin cases. The numbers are too low, and the malformations too diverse to be conclusive as to any cause-relationship (2).

A follow-up of the earlier Drugline case has been performed. Atorvastatin treatment was continued until week 10 of pregnancy. The pregnancy proceeded normally and a perfectly healthy baby was born in week 38 (3).