Publication related to RSI or an RSI staff member
Association between labetalol use for hypertension in pregnancy and adverse infant outcomes.
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.
Authors
- Xie, Ri-hua, 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, Yanfang, 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, Daniel, 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, Donald, 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, Mark C, 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, Kara, Nerenberg K, Department of Medicine, University of Ottawa Faculty of Medicine, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
- Wen, Shi Wu, 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.
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.
