Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Pregnancy Hypertens. 2021 Mar;23:123-130. doi: 10.1016/j.preghy.2020.11.014. Epub 2020 Dec 11.
Preeclampsia is a serious complication of pregnancy which increases the morbidity and mortality of both the fetus and pregnant woman. It is characterized by imbalances in angiogenesis, inflammation and endothelial dysfunction which cause the development of hypertension and proteinuria, sometimes progressing into a multisystem disorder. The aim of this systematic review was to analyze all the available data on statins and preeclampsia.
MEDLINE/PubMed, OVID, EMBASE, Web of Sciences, and SCOPUS were searched from inception to May 5, 2020. Any study evaluating the effects of statins on women with preeclampsia or HELLP syndrome or who were at risk for it has been included as well as the studies on the placenta of preeclamptic women.
12 articles which included 136 pregnant women and 35 placental samples from hypertensive and normotensive women were analyzed. They showed contradictory effects of statins on blood pressure in preeclampsia, on soluble FMS-like tyrosine kinase-1 (sFlt-1) as well as soluble endoglin (sEng). However, statins caused a significant dose-dependent reduction of sFlt-1 secretion from isolated cytotrophoblasts and an increased secretion of sEng (at least in some studies) in primary HUVECs and placental explants obtained from patients with preeclampsia. Statins also increased eNOS in preeclamptic placentas. Statins were beneficial for patients with antiphospholipid syndrome (APS) preventing preeclampsia and it seems that they might prevent complications of HELLP.
It seems that statins might be beneficial for preventing or treating preeclampsia. Nevertheless, further studies are needed to provide definitive conclusions regarding these effects of statins.
子痫前期是一种严重的妊娠并发症，会增加胎儿和孕妇的发病率和死亡率。其特征是血管生成、炎症和内皮功能障碍失衡，导致高血压和蛋白尿的发展，有时会发展为多系统疾病。本系统评价的目的是分析所有关于他汀类药物和子痫前期的可用数据。
从建库到 2020 年 5 月 5 日，我们在 MEDLINE/PubMed、OVID、EMBASE、Web of Sciences 和 SCOPUS 上进行了检索。纳入评估他汀类药物对子痫前期、HELLP 综合征或有子痫前期风险的妇女以及子痫前期妇女胎盘影响的研究，以及评估他汀类药物对高血压和正常血压妇女胎盘的研究。
分析了 12 篇文章，这些文章共纳入了 136 名孕妇和 35 名来自高血压和正常血压妇女的胎盘样本。它们显示他汀类药物对子痫前期血压、可溶性 FMS 样酪氨酸激酶-1（sFlt-1）和可溶性内皮糖蛋白（sEng）的影响具有争议性。然而，他汀类药物可显著剂量依赖性地减少从分离的滋养细胞中分泌 sFlt-1，并增加从子痫前期患者获得的原代 HUVEC 和胎盘外植体中分泌 sEng（至少在一些研究中）。他汀类药物还增加了子痫前期胎盘中的 eNOS。他汀类药物对抗磷脂抗体综合征（APS）患者有益，可以预防子痫前期，而且似乎可以预防 HELLP 的并发症。
他汀类药物可能对预防或治疗子痫前期有益。然而，需要进一步的研究来提供关于他汀类药物这些作用的明确结论。
