First year of life after the use of atenolol in pregnancy associated hypertension.

Abstract

SUMMARY We describe the results of a prospective study in which 120 women who developed hypertension in the last trimester of pregnancy were randomly allocated in double blind manner to atenolol or placebo. The mean duration of treatment was five weeks. The only difference between groups during the neonatal period was in respiratory distress syndrome, mainly related to spontaneous premature labour, which occurred in six placebo group

Update on the Use of Antihypertensive Drugs in Pregnancy

“…14 Further reassurance is derived from a 1-year postpartum follow-up study, which showed normal development of infants exposed to atenolol in utero. 49 Maternal outcomes are improved with the use of ␤-blockers, with effective control of maternal BP, decreased incidence of severe hypertension, and decreased rate of preterm admission to hospital 14 ; they have been found in a recent Cochrane analysis to be more effective in lowering BP compared with methyldopa in 10 trials. 5 Labetalol, a nonselective ␤-blocker with vascular ␣ 1 -receptor blocking capabilities, has gained wide acceptance in pregnancy.…”

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…Babies of antihypertensive (mainly methyldopa)-treated mothers (vs. normtensive controls) have excess delayed fine-motor function at 6 months of age, while those of placebo-treated hypertensive mothers more frequently had 'questionable' neurological assessment and delayed grossmotor function at 12 months [511]. However other small RCTs of methyldopa [512], atenolol [347], and nifedipine [513] did not observe negative impacts on child development. Methyldopa (but not labetalol) may be associated with lower IQ; the duration of treatment being an independent negative predictor of children's Performance IQ [514].…”

“…In comparative trials (usually of beta-blockers vs. methyldopa), beta-blockers (i.e., labetalol, pindolol, metoprolol, or oxprenolol) were more effective antihypertensives than methyldopa (RR 0.75; 95% CI 0.58-0.94), without other differences in outcomes [246,347] (see 'Aspects of care specific to women with pre-existing hypertension' and 'Effects on long-term child development').…”

“…The definitive CHIPS (Control of Hypertension In Pregnancy Study) RCT addressing the issue of BP targets in non-severe hypertension will publish its results in 2014 [345]. No reliable long-term developmental outcome data exist [346,347] (see Effect on long-term child development).…”

Antihypertensive therapy in pregnancy

“…In this respect, while several recent small studies have assessed some measures of fetal and neonatal growth, development, and function [17][18][19], the continued preference of many workers for methyldopa as the first-line agent for blood pressure control in pregnancy relates to its apparent safety, demonstrated, albeit in small numbers, through 7.5 years follow-up of children exposed in utero [20].…”