Glycemia in newborns of hypertensive mothers according to maternal treatment

Darcie, Silvana; Leone, Cléa Rodrigues; Calil, Valdenise Martins Laurindo Tuma; Prescinotti, Elizete P.; Kahhale, Soubhi; Zugaib, Marcelo

doi:10.1590/s0041-87812004000500004

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…110 Regarding neonatal glucose concentrations, there was no significant difference between mothers who received either isradipine, atenolol or low sodium diet (control group). 111 As far as fetal growth is concerned, atenolol and labetalol treatment in mild PIH and mild PE, respectively, were associated with fetal growth restriction, whereas early antihypertensive treatment with oxprenolol had no such effect. [112][113][114][115] A meta-analysis of the effect of oral antihypertensive treatment in cases of mild to moderate PIH concluded that greater decrease of blood pressure was associated with fetal growth restriction.…”

Section: Follow-upmentioning

confidence: 98%

Pregnancy-Induced hypertension

et al. 2015

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pregnancy-induced hypertension (pIh) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (sbp) >140 mmhg and diastolic blood pressure (dbp) >90 mmhg. It is classified as mild (sbp 140-149 and dbp 90-99 mmhg), moderate (sbp 150-159 and dbp 100-109 mmHg) and severe (SBP ≥160 and DBP ≥110 mmHg). PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and preeclampsia (pe), c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. pIh is a major cause of maternal, fetal and newborn morbidity and mortality. women with pIh are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. ambulatory blood pressure monitoring over a period of 24 h seems to have a role in predicting deterioration from gestational hypertension to pe. antiplatelet drugs have moderate benefits when used for prevention of pe. treatment of pIh depends on blood pressure levels, gestational age, presence of symptoms and associated risk factors. non-drug management is recommended when sbp ranges between 140-149 mmhg or dbp between 90-99 mmhg. blood pressure thresholds for drug management in pregnancy vary between different health organizations. according to 2013 esh/esc guidelines, antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥150/95 mmHg. Initiation of antihypertensive treatment at values ≥140/90 mmHg is recommended in women with a) gestational hypertension, with or without proteinuria, b) pre-existing hypertension with the superimposition of gestational hypertension or c) hypertension with asymptomatic organ damage or symptoms at any time during pregnancy. methyldopa is the drug of choice in pregnancy. atenolol and metoprolol appear to be safe and effective in late pregnancy, while labetalol has an efficacy comparable to methyldopa. angiotensin-converting enzyme (ace) inhibitors and angiotensin II antagonists are contraindicated in pregnancy due to their association with increased risk of fetopathy.

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Section: Follow-upmentioning

confidence: 98%

Pregnancy-Induced hypertension

et al. 2015

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“…Amongst the 18 RCTs included, 15 were classified as having a high risk of overall bias [ 28 , 36 , 38 , 41 , 42 , 44 , 45 , 46 , 47 , 50 , 51 , 53 , 55 , 59 , 63 ], two had some concerns [ 33 , 40 ] and one low risk [ 29 ]. Most of the RCTs had some concerns for the domains of the randomization process since the process of allocation concealment was not mentioned, which describes deviations from the intended interventions and bias due to selection of the reported results with an absence of an a priori registered trial protocol.…”

Section: Resultsmentioning

confidence: 99%

“…Forty-seven out of the 55 included articles investigated the occurrence of hypoglycemia in neonates exposed to beta-blockers either in utero or during lactation [ 26 , 28 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 49 , 50 , 52 , 53 , 54 , 55 , 57 , 58 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 70 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ]. Table 10 shows 34 of the articles reporting hypoglycemia and the definitions used by the authors [ 26 , 28 , 29 , 30 , 31 ,…”

Section: Resultsmentioning

confidence: 99%

“…Eight articles [ 28 , 32 , 35 , 37 , 39 , 41 , 43 , 49 ] studying the blood glucose levels in neonates compared a group exposed to beta-blockers with a control group of neonates non-exposed to beta-blockers in utero. Five out of these eight articles [ 32 , 35 , 39 , 41 , 43 ] showed a significantly higher risk for hypoglycemia in neonates exposed to beta-blockers in utero ( Table 10 ).…”

Section: Resultsmentioning

confidence: 99%

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The Risk for Neonatal Hypoglycemia and Bradycardia after Beta-Blocker Use during Pregnancy or Lactation: A Systematic Review and Meta-Analysis

Bruin

Dalen

Franx

et al. 2022

IJERPH

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Beta-blockers are often used during pregnancy to treat cardiovascular diseases. The described neonatal side effects of maternal beta-blocker use are hypoglycemia and bradycardia, but the evidence base for these is yet to be evaluated comprehensively. Hence, this systematic review and meta-analysis was performed to evaluate the potential increased risk for hypoglycemia and bradycardia in neonates exposed to beta-blockers in utero or during lactation. A systematic search of English-language human studies was conducted until 21 April 2021. Both observational studies and randomized controlled trials investigating hypoglycemia and/or bradycardia in neonates following beta-blocker exposure during pregnancy and lactation were included. All articles were screened by two authors independently and eligible studies were included. Pair-wise and proportion-based meta-analysis was conducted and the certainty of evidence (CoE) was performed by standard methodologies. Of the 1.043 screened articles, 55 were included in this systematic review. Our meta-analysis showed a probable risk of hypoglycemia (CoE—Moderate) and possible risk of bradycardia (CoE—Low) in neonates upon fetal beta-blocker exposure. Therefore, we suggest the monitoring of glucose levels in exposed neonates until 24 h after birth. Due to the limited clinical implication, monitoring of the heart rate could be considered for 24 h. We call for future studies to substantiate our findings.

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“…Authors show a low prevalence of colonization by penicillin-resistant strains which indicates that it is not necessary to substitute ampicilin or amoxicilin to effectively treat otitis and sinusitis caused by H. influenzae in the area where the study was conducted. DARCIE S et al 3 have evaluated the evolution of glycemic levels in newborns of hypertensive mothers according to maternal treatment (isradipine, atenolol, or low sodium diet). Their results suggest a similar effect of the 3 types of treatment upon newborn glycemia.…”

Section: Note Thatmentioning

confidence: 99%

In the october 2004 issue of Clínicas

Rocha-e-Silva

2004

Rev. Hosp. Clin.

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Glycemia in newborns of hypertensive mothers according to maternal treatment

Cited by 9 publications

References 17 publications

Pregnancy-Induced hypertension

Pregnancy-Induced hypertension

The Risk for Neonatal Hypoglycemia and Bradycardia after Beta-Blocker Use during Pregnancy or Lactation: A Systematic Review and Meta-Analysis

In the october 2004 issue of Clínicas

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