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Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011.
Matern Child Health J. 2018 02; 22(2):237-246.MC

Abstract

Background Small for gestational age (SGA) birth is associated with poor long-term health outcomes. It is unclear whether maternal antihypertensive medication increases risk of SGA independently of maternal hypertension. Methods We analyzed associations between maternal hypertension and antihypertensive medication use and SGA among non-malformed singleton controls in the National Birth Defects Prevention Study. We defined SGA as birthweight < 10th percentile for a given gestational age, sex, race/ethnicity, and parity. We included 1045 SGA and 10,019 non-SGA births. We used logistic regression to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). We assessed interaction between hypertension, antihypertensive use, and maternal race/ethnicity and age. Results Overall, 122 (11.7%) SGA and 892 (8.9%) non-SGA mothers reported hypertension and 21 (2.0%) SGA and 154 (1.5%) non-SGA mothers reported antihypertensive use. The most commonly reported medications were centrally-acting antiadrenergics, β-blockers, calcium channel blockers, and diuretics. Compared to normotensive pregnancies, maternal hypertension, regardless of treatment (AOR, 1.49 [95% CI, 1.20, 1.86]), and untreated maternal hypertension [AOR, 1.46 (95% CI, 1.15, 1.86)] were associated with SGA. We observed a positive, but not significant, association between antihypertensive use and SGA. SGA risk varied by maternal race/ethnicity, being highest among Hispanic mothers, and age, being highest among mothers ≥ 35 years, but statistical tests for interaction were not significant. Conclusions Consistent with the literature, our findings suggest that maternal hypertension slightly increases SGA risk. We did not observe an appreciably increased SGA risk associated with antihypertensive medication use beyond that of the underlying maternal hypertension.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Fisher SC
Congenital Malformations Registry, New York State Department of Health, Albany, NY, USA. sarah.fisher@health.ny.gov.
Van Zutphen AR
Congenital Malformations Registry, New York State Department of Health, Albany, NY, USA. Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA.
Romitti PA
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
Browne ML
Congenital Malformations Registry, New York State Department of Health, Albany, NY, USA. Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA.
National Birth Defects Prevention Study
No affiliation info available

MeSH

AdultAntihypertensive AgentsCase-Control StudiesFemaleGestational AgeHumansHypertensionHypertension, Pregnancy-InducedInfant, NewbornInfant, Small for Gestational AgeMaternal AgeMothersPre-EclampsiaPregnancyPregnancy OutcomeRetrospective StudiesSocioeconomic FactorsTreatment Outcome

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

29124624

Citation

Fisher, Sarah C., et al. "Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011." Maternal and Child Health Journal, vol. 22, no. 2, 2018, pp. 237-246.
Fisher SC, Van Zutphen AR, Romitti PA, et al. Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011. Matern Child Health J. 2018;22(2):237-246.
Fisher, S. C., Van Zutphen, A. R., Romitti, P. A., & Browne, M. L. (2018). Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011. Maternal and Child Health Journal, 22(2), 237-246. https://doi.org/10.1007/s10995-017-2395-8
Fisher SC, et al. Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011. Matern Child Health J. 2018;22(2):237-246. PubMed PMID: 29124624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011. AU - Fisher,Sarah C, AU - Van Zutphen,Alissa R, AU - Romitti,Paul A, AU - Browne,Marilyn L, AU - ,, PY - 2017/11/11/pubmed PY - 2019/1/4/medline PY - 2017/11/11/entrez KW - Antihypertensive medication KW - Hypertension KW - National Birth Defects Prevention Study KW - Pregnancy KW - Small for gestational age SP - 237 EP - 246 JF - Maternal and child health journal JO - Matern Child Health J VL - 22 IS - 2 N2 - Background Small for gestational age (SGA) birth is associated with poor long-term health outcomes. It is unclear whether maternal antihypertensive medication increases risk of SGA independently of maternal hypertension. Methods We analyzed associations between maternal hypertension and antihypertensive medication use and SGA among non-malformed singleton controls in the National Birth Defects Prevention Study. We defined SGA as birthweight < 10th percentile for a given gestational age, sex, race/ethnicity, and parity. We included 1045 SGA and 10,019 non-SGA births. We used logistic regression to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). We assessed interaction between hypertension, antihypertensive use, and maternal race/ethnicity and age. Results Overall, 122 (11.7%) SGA and 892 (8.9%) non-SGA mothers reported hypertension and 21 (2.0%) SGA and 154 (1.5%) non-SGA mothers reported antihypertensive use. The most commonly reported medications were centrally-acting antiadrenergics, β-blockers, calcium channel blockers, and diuretics. Compared to normotensive pregnancies, maternal hypertension, regardless of treatment (AOR, 1.49 [95% CI, 1.20, 1.86]), and untreated maternal hypertension [AOR, 1.46 (95% CI, 1.15, 1.86)] were associated with SGA. We observed a positive, but not significant, association between antihypertensive use and SGA. SGA risk varied by maternal race/ethnicity, being highest among Hispanic mothers, and age, being highest among mothers ≥ 35 years, but statistical tests for interaction were not significant. Conclusions Consistent with the literature, our findings suggest that maternal hypertension slightly increases SGA risk. We did not observe an appreciably increased SGA risk associated with antihypertensive medication use beyond that of the underlying maternal hypertension. SN - 1573-6628 UR - https://www.unboundmedicine.com/medline/citation/29124624/Maternal_Hypertension_Antihypertensive_Medication_Use_and_Small_for_Gestational_Age_Births_in_the_National_Birth_Defects_Prevention_Study_1997_2011_ DB - PRIME DP - Unbound Medicine ER -