Abstract

There is a lack of evidence regarding antihypertensive medicine use in pregnancy. To compare maternal and neonatal outcomes of women on an antihypertensive agent with gestational hypertension (GHTN), chronic hypertension (CHTN) and preeclampsia (preE). The Consortium on Safe Labor electronic database from 19 hospitals across the US with 228,668 deliveries during 2002-2008 was used to extract data on gravidas with GHTN, CHTN, and preE on a calcium channel blocker, methyldopa, or beta blocker. Univariate and multivariate analyses were performed. There were 637 women on beta blockers, 207 on calcium channel blockers, 249 on Methyldopa, and 6869 women with hypertension on no agent (control group). Women on beta blockers had an increased risk of ICU admission, OR 3.74 (95% CI 1.8-7.6). Risk of thrombosis was increased in women on beta blockers, OR 3.6 (95% CI 1.4-9.2) and calcium channel blockers, OR 10.6 (95% CI 3.8-29.2). There was no increased risk of small for gestational age babies. There was a small, increased risk of NICU admission for babies of women on calcium channel blockers, OR 1.7 (95% CI 1.2-2.6) and methyldopa, OR 1.9 (95% CI 1.4-2.7). Beta and calcium channel blocker use was associated with significant risks of morbidity compared to Methyldopa use by gravid women with hypertensive disease.

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