Aims
The objective of this meta‐analysis was to determine whether maternal exposure to statins is associated with increased rates of major congenital malformations and other adverse pregnancy outcomes.
Methods
PubMed/Medline, Web of Science and Reprotox® databases were searched. Cohort and case control studies with prenatal exposure to statins were included.
Results
Analysis of five cohort studies and one case–control study showed no significant increase in rate of major congenital malformations when the exposed group was compared with the control ([OR 1.27; 95% CI 0.80–2.04], [aOR 1.05; 95% CI 0.84–1.31]). A significant increase in heart defect risk was detected in the statin‐exposed group when unadjusted ORs were combined (OR 2.47; 95% CI 1.36–4.49). Further analysis of the same outcome by using adjusted ORs showed no significant increase in heart defect risk in the statin‐exposed group compared with the controls (aOR 1.24; 95% CI 0.93–1.66). A significantly lower live birth rate (OR 0.60, 95% CI 0.49–0.75) and a higher spontaneous abortion rate (OR 1.36; 95% Cl 1.06–1.75) were detected in the statin‐exposed group.
Conclusions
Gestational statin exposure was not associated with a significant increase in risk of major congenital malformations, heart defects and other adverse pregnancy outcomes, except spontaneous abortion and live birth rate, which may be associated with maternal comorbidity and other unadjusted risk factors. Further research focusing on particular statins is needed to draw more definitive conclusions.
We aimed to analyze 10-year experience of WAIHA patients at a single referral center in Turkey. Clinical data, survival outcome of sixty patients who were diagnosed with WAIHA were retrospectively analyzed. All the patients were direct antiglobulin test (DAT) positive. In 21 (30%) patients, IgG plus C3d DAT positivity was documented. 16 patients were secondary WAIHA and most common underlying causes were lymphoproliferative diseases (5 patients) and connective tissue disease (8 patients). Corticosteroids were first choice as a first line therapy with 54.5% CR and 40.2% PR rates. 43.3% of the patients relapsed after a median 12 months. In relapsed patients, rituximab and splenectomy achieved 85% overall response rates. The median OS was not reached. The median DFS was 40 months (95% CI, 19.6-60.4). OS and DFS at 36 months were 89.6% and 51.1%, respectively. DFS at 36 months was lower in patients with IgG plus C3d positive DAT than patients with only positive Ig G DAT (36 vs. 54%) but this difference could not reach statistical significance (p = 0.23). WAIHA was a rare disease with a good prognosis. Corticosteroids were the first option and splenectomy and rituximab received good responses in relapsed patients. Attention should be paid especially in patients with IgG plus C3d DAT positivity since lower DFS were reported. Characteristics and pathogenesis of patients with IgG plus C3d DAT positivity was still an obscure.
ÖZET Birinci Basamakta Obezite Yönetimine Nitel Çalışmaların Katkısı Son yıllarda obezite eşlik eden morbidite ve mortalitesi nedeniyle önemli sağlık problemlerinden biri haline gelmiştir. Önerilen tüm tedavi yöntemlerine karşın sıklığı tüm dünyada artmaktadır. Obezite sorununa acil çözüm bulmak için yeni tedavi yaklaşımlarına ihtiyaç duyulmaktadır. Bulaşıcı olmayan hastalıkların yönetiminde kilit role sahip olan aile hekimleri araştırmalarında nitel (kalitatif) ve nicel (kantitatif) yöntemleri bir arada kullanarak uygulamayı yönlendirecek önemli bilgiler elde edebilirler.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.