Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 1;32(6):370-377.
doi: 10.1097/MOL.0000000000000790.

Management of familial hypercholesterolemia in pregnancy

Dorothy F Graham  1 , Frederick J Raal  2
Affiliations
Review

Management of familial hypercholesterolemia in pregnancy

Dorothy F Graham et al. Curr Opin Lipidol. .

Abstract

Purpose of review: To highlight quandaries and review options for the management of familial hypercholesterolemia (FH) during pregnancy.

Recent findings: Women with FH face barriers to effective care and consequently face significant disease related long term morbidity and mortality.Pregnancy includes major maternal physiological changes resulting in exacerbation of maternal hypercholesterolemia compounded by the current practice of cessation or reduction in the dose of lipid-lowering therapy during pregnancy and lactation that may impact short and long term cardiac morbidity and mortality. Although lipoprotein apheresis is the treatment of choice for high- risk FH patients, reassuring safety evidence for the use of statins during pregnancy is mounting rapidly. However, it will be some time before subtle effects on the development of the offspring can be definitively excluded. Women with homozygous FH or with an established atherosclerotic vessel or aortic disease should be offered therapy with statins during pregnancy if lipoprotein apheresis is not readily available. Pregnancy outcomes tend to be favourable in women with FH. We have reviewed the currently available evidence regarding the risks and benefits of treatment options for FH during pregnancy.

PubMed Disclaimer

References

    1. Besseling J, Hovingh GK, Huijgen R, et al. Statins in familial hypercholesterolemia: consequences for coronary artery disease and all-cause mortality. J Am Coll Cardiol 2016; 68:252–260.
    1. Luirink IK, Wiegman A, Kusters DM, et al. 20- year follow-up of statins in children with familial hypercholesterolemia. NEJM 2019; 381:1547–1556.
    1. Humphries SE, Cooper JA, Seed M, et al. Coronary heart disease mortality in treated familial hypercholesterolaemia: update of the UK Simon Broome FH register. Atherosclerosis 2018; 274:41–46.
    1. Balla S, Ekpo EP, Wilemon KA, et al. Women living with familial hypercholesterolemia: challenges and considerations surrounding their care. Curr Atheroscler Rep 2020; 22:60–80.
    1. Piechota W, Staszewski A. Reference ranges of lipids and apolipoproteins in pregnancy. Eur J Obstet Gynecol Reprod Biol 1992; 45:27–35.

MeSH terms

Substances