Use of antihypertensive medications in pregnancy and the risk of adverse perinatal outcomes: McMaster Outcome Study of Hypertension In Pregnancy 2 MOS HIP 2Report as inadecuate




Use of antihypertensive medications in pregnancy and the risk of adverse perinatal outcomes: McMaster Outcome Study of Hypertension In Pregnancy 2 MOS HIP 2 - Download this document for free, or read online. Document in PDF available to download.

BMC Pregnancy and Childbirth

, 1:6

First Online: 23 November 2001Received: 12 August 2001Accepted: 23 November 2001

Abstract

BackgroundUncertainty remains about the potential harmful effects of antihypertensive therapy on the developing fetus, especially for beta-blockers βb.

MethodsWe prospectively enrolled all singleton women with a blood pressure ≥ 140-90 mm Hg during pregnancy. The main analysis included 1948 women with all forms of hypertension and compared the use of βb drugs, non-βb drugs or a combination of both, to no treatment. The primary study outcome was a composite of the diseases of prematurity, need for assisted ventilation for greater than 1 day, or perinatal death. A sub-group analysis evaluated the four treatment options among 583 singleton women with chronic hypertension before 20 weeks gestation.

ResultsIn the main analysis, no association was observed between βb use and the primary composite outcome adjusted odds ratio OR 1.4, 95% CI 0.9–2.2, while an association was seen with non-βb therapy OR 5.0, 95% CI 2.6–9.6 and combination therapy OR 2.9, 95% CI 1.8–4.7. In the sub-group of 583 women with hypertension before 20 weeks, use of a non-βb drug OR 4.9, 95% CI 1.7–14.2 or combination therapy OR 2.9. 95% CI 1.1–7.7 was significantly associated with the primary composite outcome, while βb monotherapy was not OR 1.4, 95% CI 0.6–3.4.

ConclusionsMaternal use of antihypertensive medications other than βbs was associated with both major perinatal morbidity and mortality, while βb monotherapy was not. The combined use of βb and non-βb medications demonstrated the strongest association. Before definitive conclusions can be drawn, a large multicentre randomized controlled trial is needed to address the issues of both maternal efficacy and fetal safety with the use of one or more antihypertensive agents in pregnancy.

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Author: Joel G Ray - Marian J Vermeulen - Elizabeth A Burrows - Robert F Burrows

Source: https://link.springer.com/



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