loading page

The effect of pravastatin on obstetrics complications associated with uteroplacental insufficiency: A systematic review and meta-analysis
  • +1
  • Ayala Hirsch,
  • Natali Ternovsky,
  • Reut Rotem,
  • Bruria Hirsh Raccah
Ayala Hirsch
Shaare Zedek Medical Center

Corresponding Author:[email protected]

Author Profile
Natali Ternovsky
Hebrew University of Jerusalem
Author Profile
Reut Rotem
Shaare Zedek Medical Center
Author Profile
Bruria Hirsh Raccah
Hebrew University of Jerusalem
Author Profile


ABSTRACT Background: Obstetrical complications involving uteroplacental insufficiency associated disorders, such as preeclampsia, intrauterine growth restriction, and obstetric antiphospholipid syndrome, share pathophysiology and risk factors with cardiovascular diseases treated with statins. Objective: To evaluate associations of statin treatment with pregnancy prolongation, and neonatal and maternal morbidity, among women with uteroplacental insufficiency disorders. Search Strategy: Electronic databases including PubMed, Medline, Embase, Clinical Trials Registry Clinicaltrials.gov, and The Cochrane Library were searched from inception to January 2022. Selection Criteria: Cohort studies and randomized controlled trials (RCTs) Data collection and analysis: Pooled odds ratios were calculated using a random-effects model; meta-regression was utilized when applicable. Main Results: The analysis included ten studies describing 1391 women with uteroplacental insufficiency-associated disorders: 703 treated with pravastatin and 688 not treated with statins. Women who received pravastatin showed significant prolongation of pregnancy (mean difference 0.44 weeks, 95%CI:0.01-0.87, p=0.04, I2=96%) and less neonatal critical care unit admission (OR=0.42, 95%CI: 0.23-0.75, p=0.004, I2=25%). Trends were observed toward a decrease in preeclampsia diagnoses (OR=0.51, 95%CI:0.25–105, p=0.07, I=44%), and perinatal death (OR=0.32, 95%CI:0.09-1.13, p=0.08, I2=54%) and an increase in birth weight (mean difference=102 grams, 95%CI: -14–212, p=0.08, I2=96%). A meta-regression analysis revealed associations between earlier gestational age at initiation of pravastatin treatment to lower risk for development of preeclampsia (R2=1) and between longer duration of pravastatin treatment to lower rate of NICU admission (R2=0.33). No dose-response effect was demonstrated. Conclusions: Pravastatin treatment in pregnancies with high risk for developing uteroplacental insufficiency disorders may prolong pregnancy duration and improve neonatal outcomes.
17 Jan 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
20 Jan 2022Assigned to Editor
20 Jan 2022Submission Checks Completed
25 Jan 2022Reviewer(s) Assigned
16 Feb 2022Review(s) Completed, Editorial Evaluation Pending
Jan 2022Published in American Journal of Obstetrics and Gynecology volume 226 issue 1 on pages S90-S91. 10.1016/j.ajog.2021.11.165