Obstetrics and fetal outcomes in pregnant women with beta-blocker treatment in maternal arrhythmia

Abstract

Aim: The aim of this study was to investigate the pregnancy prognosis of patients taking beta-blockers for the treatment of cardiac arrhythmias.
 Materials and Method: This study was a retrospective observational study involving 50 pregnant women with cardiac arrhythmias and 55 healthy pregnant women, admitted between January 1, 2020 and January 1, 2022, to Ankara City Hospital. Beta-blockers were classified into three groups: metaprolol, propranolol, and bisoprolol. The use of beta-blockers was examined in two groups: high-dose and low-dose. For pregnancy outcome, birth week, birth weight and birth weight Z-score, the bHCG MoM and PAPP-A MoM, neonatal APGAR score, and neonatal intensive care unit admission rates were determined. Statistical analysis was performed using IBM SPSS Statistics 26.0 (IBM Corp, Armonk, NY, USA). Shapiro-Wilk and Kolmogorov-Smirnov tests were both used to evaluate normality of variables. Groups were compared using the Student t-test and the Mann-Whitney U test. P-values < 0.05 were considered as statistically significant.
 Results: The patient group taking beta-blockers had a statistically significant earlier delivery week than the group without beta-blocker use (p=0.000). The rate of primary cesarean deliveries was higher in the study group (p=0.007). Birth weight and APGAR score at the fifth minute was significantly lower in the study group, and NICU admission rate was significantly higher (p=0.006, p=0.000 and p=0.000, respectively). 
 Conclusion: Beta-blockers, a first-line therapy for maternal arrhythmias, may affect fetal development and pregnancy outcomes. İt is recommended that these drugs to be administered are meticulously selected for appropriate subgroups, with lowest effective doses