FH-vrouwen verliezen mediaan 2,9 jaar lipidenverlagende behandeling rond elke kinderwens
Een Noorse cohortstudie binnen de FH-FEMINA-trial volgde 27 vrouwen met familiaire hypercholesterolemie van 36 weken zwangerschap tot één jaar postpartum of het einde van de borstvoeding. De totale zwangerschap-gerelateerde behandelvrije tijd bedroeg per vrouw mediaan 2,9 jaar (range 0,8–12 jaar) over alle bevallingen samen.
De zwangerschap zelf vormde slechts 42% van die behandelvrije periode; de pré- en postpartum maanden waren samen goed voor 58%. Inclusief onbehandelde jaren in de jeugd en vóór diagnose lag de levenslange behandelvrije periode op mediaan 66% van de levensduur.
De auteurs — onder wie Jeanine Roeters van Lennep (Erasmus MC) en Janneke Mulder, beiden actief binnen het Nederlandse LEEFH-cascadescreeningsprogramma — pleiten voor vroege FH-diagnose bij meisjes, snelle hervatting van lipidenverlagende therapie meteen na de borstvoedingsperiode en tussen zwangerschappen door, en dringend meer onderzoek naar de veiligheid van statines tijdens zwangerschap en lactatie.
Abstract (original)
BACKGROUND AND AIMS: Women with familial hypercholesterolaemia (FH) lose substantial treatment time during their reproductive years as most lipid-lowering therapies are contraindicated from the preconception through the end of breastfeeding. We examined the duration of real-life pregnancy-related off-treatment time in 27 women with FH in Norway. METHODS: Women with FH in Norway who had completed the ongoing FH-FEMINA study (ClinicalTrials.gov ID NCT05367310) were included. Women were followed from 36th week of gestation and until one year after delivery or until end of breastfeeding. Information on use of medication before, during and after the current and previous pregnancies was collected. Pregnancy-related off-treatment time was calculated from discontinuation of lipid-lowering therapy when planning pregnancy, throughout pregnancy, and after delivery. RESULTS: The total duration of pregnancy-related off-treatment time after all childbirths (median 1, range 1-3) per woman was a median of 2.9 years (25th-75th percentile; 1.6-4.0), ranging from 0.8 to 12 years. The pregnancy itself accounted for median of 42.1% of the pregnancy-related off-treatment time, whereas the time before and after pregnancy accounted for a median of 57.9% (range 11.4% to 91.2%). When including untreated years in childhood and/or prior to diagnosis, the lifelong off-treatment time represented a median of 66.3% (range 41.9 to 100%) of lifetime without treatment. CONCLUSION: Early diagnosis and initiation of treatment is essential in girls with FH to compensate for pregnancy-related off-treatment time later in life. To minimize these pregnancy-related off-treatment periods, healthcare professionals should support women with FH to resume lipid-lowering therapy immediately after breastfeeding and between pregnancies. In addition, more knowledge on the potential effects of statin use during pregnancy and breastfeeding on maternal and offspring health is urgently needed.
Dit artikel is een samenvatting van een publicatie in Atherosclerosis. Voor het volledige artikel, alle details en referenties verwijzen wij u naar de oorspronkelijke bron.
Lees het volledige artikelDOI: 10.1016/j.atherosclerosis.2026.120668
