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Association between labetalol use for hypertension in pregnancy and adverse infant outcomes.
Eur J Obstet Gynecol Reprod Biol. 2014 Apr; 175:124-8.EJ

Abstract

OBJECTIVE

Labetalol and methyldopa are the two antihypertensive drugs most frequently used to control blood pressure for hypertensive disorders of pregnancy. The objective of this study was to assess if labetalol is associated with poor infant outcomes.

STUDY DESIGN

Retrospective population-based cohort study using the linked maternal/infant databases in the Province of Saskatchewan. Women with a diagnosis of a hypertensive disorder of pregnancy who delivered a singleton in Saskatchewan from January 1, 1990 to December 31, 2005 and who were dispensed only labetalol or only methyldopa were included in the study. Occurrences of small for gestational age (SGA)<10th percentile, SGA<3rd percentile, preterm birth, stillbirth, hospitalization for respiratory distress syndrome (RDS), sepsis, and seizure during infancy, and infant death were compared. Multiple logistic regression analysis was performed to adjust for potential confounding.

RESULTS

A total of 1223 eligible women were included in the final analysis. Among them, 300 received labetalol only and 923 received methyldopa only during pregnancy. For women with chronic hypertension, the rate of hospitalization for RDS, sepsis, and seizure during infancy was significantly higher for infants born to mothers who were dispensed labetalol only as compared with infants born to mothers who were dispensed methyldopa only (adjusted odds ratio (OR) 1.51, 95% confidence interval (CI) 1.02-2.22).

CONCLUSION

Compared with methyldopa, the use of labetalol for chronic hypertension of pregnancy may be associated with increased rate of hospitalization during infancy.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Xie RH
Department of Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, China; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
Guo Y
OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
Krewski D
McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, Ontario, Canada K1N 6N5; Risk Sciences International, 325 Dalhousie Street, Ottawa, Ontario, Canada K1N 7G2; Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5.
Mattison D
McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, Ontario, Canada K1N 6N5; Risk Sciences International, 325 Dalhousie Street, Ottawa, Ontario, Canada K1N 7G2.
Walker MC
OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5.
Nerenberg K
Department of Medicine, University of Ottawa Faculty of Medicine, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
Wen SW
OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5; School of Public Health, Central South University, 110 Xiang Ya Road, Changsha, Hunan 410078, China. Electronic address: swwen@ohri.ca.

MeSH

AdultAntihypertensive AgentsFemaleHumansHypertension, Pregnancy-InducedInfant, NewbornInfant, Newborn, DiseasesLabetalolMethyldopaPregnancyRetrospective Studies

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24502872

Citation

Xie, Ri-hua, et al. "Association Between Labetalol Use for Hypertension in Pregnancy and Adverse Infant Outcomes." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 175, 2014, pp. 124-8.
Xie RH, Guo Y, Krewski D, et al. Association between labetalol use for hypertension in pregnancy and adverse infant outcomes. Eur J Obstet Gynecol Reprod Biol. 2014;175:124-8.
Xie, R. H., Guo, Y., Krewski, D., Mattison, D., Walker, M. C., Nerenberg, K., & Wen, S. W. (2014). Association between labetalol use for hypertension in pregnancy and adverse infant outcomes. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 175, 124-8. https://doi.org/10.1016/j.ejogrb.2014.01.019
Xie RH, et al. Association Between Labetalol Use for Hypertension in Pregnancy and Adverse Infant Outcomes. Eur J Obstet Gynecol Reprod Biol. 2014;175:124-8. PubMed PMID: 24502872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between labetalol use for hypertension in pregnancy and adverse infant outcomes. AU - Xie,Ri-hua, AU - Guo,Yanfang, AU - Krewski,Daniel, AU - Mattison,Donald, AU - Walker,Mark C, AU - Nerenberg,Kara, AU - Wen,Shi Wu, Y1 - 2014/01/19/ PY - 2013/10/28/received PY - 2014/01/07/revised PY - 2014/01/12/accepted PY - 2014/2/8/entrez PY - 2014/2/8/pubmed PY - 2014/12/18/medline KW - Chronic hypertension KW - Hospitalization KW - Labetalol KW - Methyldopa KW - Pregnancy SP - 124 EP - 8 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 175 N2 - OBJECTIVE: Labetalol and methyldopa are the two antihypertensive drugs most frequently used to control blood pressure for hypertensive disorders of pregnancy. The objective of this study was to assess if labetalol is associated with poor infant outcomes. STUDY DESIGN: Retrospective population-based cohort study using the linked maternal/infant databases in the Province of Saskatchewan. Women with a diagnosis of a hypertensive disorder of pregnancy who delivered a singleton in Saskatchewan from January 1, 1990 to December 31, 2005 and who were dispensed only labetalol or only methyldopa were included in the study. Occurrences of small for gestational age (SGA)<10th percentile, SGA<3rd percentile, preterm birth, stillbirth, hospitalization for respiratory distress syndrome (RDS), sepsis, and seizure during infancy, and infant death were compared. Multiple logistic regression analysis was performed to adjust for potential confounding. RESULTS: A total of 1223 eligible women were included in the final analysis. Among them, 300 received labetalol only and 923 received methyldopa only during pregnancy. For women with chronic hypertension, the rate of hospitalization for RDS, sepsis, and seizure during infancy was significantly higher for infants born to mothers who were dispensed labetalol only as compared with infants born to mothers who were dispensed methyldopa only (adjusted odds ratio (OR) 1.51, 95% confidence interval (CI) 1.02-2.22). CONCLUSION: Compared with methyldopa, the use of labetalol for chronic hypertension of pregnancy may be associated with increased rate of hospitalization during infancy. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/24502872/Association_between_labetalol_use_for_hypertension_in_pregnancy_and_adverse_infant_outcomes_ DB - PRIME DP - Unbound Medicine ER -