The role of statins during pregnancy on maternal risk of preeclampsia: a systematic review and meta-analysis
Notice bibliographique
Résumé
BACKGROUND: Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality, characterized by angiogenic imbalance and systemic dysfunction after 20 weeks of gestation. Statins, particularly pravastatin, have showed potential in prevention due to their anti-inflammatory and endothelial-protective properties, though safety in pregnancy remains uncertain. This systematic review and meta-analysis aimed to evaluate the efficacy of statins and their association with maternal risk of preeclampsia. METHODS: Two independent reviewers systematically searched data from PubMed, Scopus, Web of Science, Cochrane, and Embase databases until December 2024 for studies evaluating statins for prevention of pre-eclampsia. Those healthy pregnant women who did not develop preeclampsia were assessed as comparators. Letters, comments, case reports, and reviews were excluded. Newcastle-Ottawa Scale (NOS) were used for assessing case-control and cohort studies. The Cochrane Risk of Bias 2.0 (RoB 2.0) were adopted for evaluating randomized trials. The primary outcome was preeclampsia. Secondary outcomes included the hypertensive disorders of pregnancy (HDP), preterm labor (PTB), neonatal birth defects, and neonatal intensive care unit (NICU) admission. The random-effects method (REM) or fixed-effects method (FEM) were employed depending on the heterogeneity. Sub-group analysis was performed to identify the source of heterogeneity. The publication bias was assessed via the funnel plot, Egger's and Begg's tests. The leave-one-out sensitivity analysis were also performed. The RevMan 5.3 and Stata 16.0 were the main software used for data extraction and analysis. RESULTS: 11 different studies covering 10,482 pregnant participants, with 456 diagnosed with preeclampsia. Results showed a pooled risk ratio (RR) of 0.78 (95% CI: 0.33 to 1.83, p = 0.57), indicating that statin use during pregnancy was not significantly associated with a reduced risk of preeclampsia. Heterogeneity among studies was high (I² = 94%, p < 0.05), suggesting variability in study populations, dosages, and statin types. The second outcomes also showed insignificant statistical difference. Sub-group analysis implied early initiation of statins may reduce preeclampsia risk during pregnancy. Sensitivity analysis revealed that no single study had significant impact on the overall effect. CONCLUSION: Due to significant heterogeneity, current evidence is insufficient to establish a definitive protective role for statins in preventing preeclampsia during pregnancy. While subgroup findings suggest that early initiation may be associated with reduced risk, these observations should be interpreted with caution and require confirmation in future high-quality trials. TRIAL REGISTRATION: The study protocol was registered with PROSPERO (No. CRD42024601996).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,031 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,019 | 0,036 |
| Bibliométrie | 0,007 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».