Chronic hypertension with related drug treatment of pregnant women and congenital abnormalities in their offspring: a population-based study

Bánhidy, Ferenc; Ács, Nándor; Puhó, Erzsébet; Czeizel, Andr̀ew E.

doi:10.1038/hr.2010.227

Cited by 35 publications

(30 citation statements)

References 38 publications

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“…After title and abstract screening, 101 abstracts were selected for full text review and thirteen (nine case-control 8, 9, 11-19 and four cohort 20-23 ) studies met final inclusion criteria. We did not identify any published RCTs.…”

Section: Resultsmentioning

confidence: 99%

The Risk of Congenital Malformations Associated With Exposure to β-Blockers Early in Pregnancy

Yakoob

Bateman

et al. 2013

Hypertension

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Beta-blockers are commonly used during the first trimester of pregnancy. Data regarding risks of congenital anomalies in offspring have not been summarized. We performed a meta-analysis to determine teratogenicity of beta-blockers in early pregnancy. A systematic literature search was performed using PubMed, EMBASE, Cochrane Clinical Trials, and hand search. Meta-analyses were conducted using random-effects models based on odds ratios (ORs). Pre-specified subgroup analyses were performed to explore heterogeneity. Randomized controlled trials or observational studies examining risks of congenital malformations associated with first trimester beta-blocker exposure compared to no exposure were included. Thirteen population-based case-control or cohort studies were identified. Based on meta-analyses, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies (OR = 1.00; 95% CI: 0.91 – 1.10, five studies). However, in analyses examining organ-specific malformations, increased odds of cardiovascular (CV) defects (OR = 2.01; 95% CI: 1.18 – 3.42; 4 studies), cleft lip/palate (CL/P) (OR = 3.11; 95% CI: 1.79 – 5.43; 2 studies) and neural tube (NT) defects (OR = 3.56; 95% CI: 1.19 – 10.67; 2 studies) were observed. The effects on severe hypospadias were non-significant (1 study). Causality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.

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Section: Resultsmentioning

confidence: 99%

The Risk of Congenital Malformations Associated With Exposure to β-Blockers Early in Pregnancy

Yakoob

Bateman

et al. 2013

Hypertension

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“…Hence we were not able to consider the specific birth defect categories that may be associated with hypertensive disorders. In this regard, we were unable to assess associations between specific congenital malformations (such as esophageal atresia and hypospadias) and hypertensive disorders that have been identified in other studies [11][12][13][14]. Another limitation concerns the outcome variable, congenital malformations, being ascertained at birth or immediately after birth.…”

Section: Discussionmentioning

confidence: 99%

Are Hypertensive Disorders in Pregnancy Associated With Congenital Malformations in Offspring? Evidence From the WHO Multicountry Cross Sectional Survey on Maternal And Newborn Health

Bellizzi¹,

Ali²,

Ábalos³

et al. 2016

Obstetrical &Amp; Gynecological Survey

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Background: Annually, around 7.9 million children are born with birth defects and the contribution of congenital malformations to neonatal mortality is generally high. Congenital malformations in children born to mothers with hypertensive disorders during pregnancy has marginally been explored. Methods: Country incidence of congenital malformations was estimated using data on the 310 401 livebirths of the WHO Multicountry Survey which reported information from 359 facilities across 29 countries. A random-effect logistic regression model was utilized to explore the associations between six broad categories of congenital malformations and the four maternal hypertensive disorders "Chronic Hypertension", "Preeclampsia" and "Eclampsia" and "Chronic hypertension with superimposed preeclampsia". Results: The occupied territories of Palestine presented the highest rates in all groups of malformation except for the "Lip/Cleft/Palate" category. Newborns of women with chronic maternal hypertension were associated with a 3.7 (95 % CI 1.3-10.7), 3.9 (95 % CI 1.7-9.0) and 4.2 (95 % CI 1.5-11.6) times increase in odds of renal, limb and lip/cleft/ palate malformations respectively. Chronic hypertension with superimposed preeclampsia was associated with a 4.3 (95 % CI 1.3-14.4), 8.7 (95 % CI 2.5-30.2), 7.1 (95 % CI 2.1-23.5) and 8.2 (95 % CI 2.0-34.3) times increase in odds of neural tube/central nervous system, renal, limb and Lip/Cleft/Palate malformations. Conclusions: This study shows that chronic hypertension in the maternal period exposes newborns to a significant risk of developing renal, limb and lip/cleft/palate congenital malformations, and the risk is further exacerbate by superimposing eclampsia. Additional research is needed to identify shared pathways of maternal hypertensive disorders and congenital malformations.

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“…Our previous study17 showed a higher risk of CAs in the offspring of pregnant women with chronic hypertension, but the different entities of CHD were not differentiated. Unfortunately, current antihypertensive drugs cannot protect the fetus from maternal hypertension 18 19.…”

Section: Discussionmentioning

confidence: 87%

Maternal hypertension with nifedipine treatment associated with a higher risk for right-sided obstructive defects of the heart: a population-based case-control study

Csáky-Szunyogh¹,

Vereczkey²,

Gerencsér

et al. 2014

Heart Asia

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Chronic hypertension with related drug treatment of pregnant women and congenital abnormalities in their offspring: a population-based study

Cited by 35 publications

References 38 publications

The Risk of Congenital Malformations Associated With Exposure to β-Blockers Early in Pregnancy

The Risk of Congenital Malformations Associated With Exposure to β-Blockers Early in Pregnancy

Are Hypertensive Disorders in Pregnancy Associated With Congenital Malformations in Offspring? Evidence From the WHO Multicountry Cross Sectional Survey on Maternal And Newborn Health

Maternal hypertension with nifedipine treatment associated with a higher risk for right-sided obstructive defects of the heart: a population-based case-control study

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