Treatment of Hypercholesterolemia in Pregnancy: Risks versus Benefits

Abstract

Objective:

To identify treatment options for hypercholesterolemia in pregnant women.

Data Sources:

A search was conducted of MEDLINE (1966–March 2004), EMBASE (1980–March 2004), and International Pharmaceutical Abstracts (1970–March 2004). Key terms included fibric acid derivatives, plant stanol/sterols, niacin, ezetimibe, vitamin E, LDL-apheresis, and fish oil.

Study Selection and Data Extraction:

The articles evaluated described hypercholesterolemia during pregnancy and lipid therapy options.

Data Synthesis:

Elevated lipid levels in pregnant women may have a negative impact on the fetus. Case reports and clinical trials from 1966 to March 2004 were evaluated for information regarding the impact of various cholesterol-lowering agents on both the mother and fetus. These case reports and trials conclude that additional studies are needed to determine their overall safety in pregnant women.

Conclusions:

Lipid-lowering therapies have differing levels of safety and efficacy and are not well studied in pregnant women. Therefore, a diet low in cholesterol and fat is the recommended treatment for hypercholesterolemia during pregnancy.