Author + information
- Avetis Hekimian,
- Lewei Duan,
- Tanya Doctorian and
- Ming-Sum Lee
The rise in cardiovascular risk factors in young people has led to an increasing number of young women being treated with statin therapy. The purpose of this study is to examine the risk of fetal congenital cardiac anomalies in association with first trimester statin exposure.
This is a retrospective cohort study that included singleton births in the Kaiser Permanente Southern California Region between 2003 and 2014. Pregnant women exposed to statins during the first trimester were identified using pharmacy dispensing records. Propensity scores for statin exposure were calculated and the statin-exposed group was matched to the non-exposed group on the logit of the propensity score using nearest neighbor matching in a 1:5 fashion with a caliper of 0.1 with no replacements.
In a cohort of 379,238 pregnancies, 280 (0.07%) were exposed to statins during the first trimester. Women exposed to statins were older. Higher proportions of women in the statin-exposed group had hypertension, dyslipidemia, diabetes, heart failure, and chronic kidney disease. Using propensity-score matching with a caliper of 0.1, 1160 unexposed controls were identified. Baseline characteristics were well-matched in the propensity score-matched cohorts. First-trimester statin exposure was associated with fetal congenital heart disease (OR 2.5, 95% CI 1.3-4.9, p < 0.008). Among the different types of congenital heart malformation, statin exposure was associated with a higher risk of fetal ventricular septal defects (OR 4.7, 95% CI 2.0-10.8, p < 0.001). No association was found between statin exposure and fetal atrial septal defects, conotruncal defects, single ventricle physiology, or a patent ductus arteriosus.
In this large population-based study, we found an association between first-trimester statin exposure and ventricular septal defects in the infant.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: Fetal Cardiology and the Patent Ductus Arteriosus
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1124-366
- 2018 American College of Cardiology Foundation