Risk for neonatal hypoglycaemia and bradycardia after beta-blocker use during pregnancy or lactation: a systematic review and meta-analysis protocol

Bruin, Rosalie de; Dalen, Sarah L van; Franx, Shamaya J; Simons, Sinno; Flint, Robert B.; Bosch, Gerbrich van den

doi:10.1136/bmjopen-2021-055292

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…If the ATD do not properly control the hyperadrenergic symptoms, beta-blockers can be used in addition [ 141 ]. These medications should be used with caution because they do cross the placental and can be responsible for neonatal hypoglycemia and/or bradycardia [ 142 ].…”

Section: Maternal Pathologies During Pregnancymentioning

confidence: 99%

Iodine and Thyroid Maternal and Fetal Metabolism during Pregnancy

2023

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Thyroid hormones and iodine are required to increase basal metabolic rate and to regulate protein synthesis, long bone growth and neuronal maturation. They are also essential for protein, fat and carbohydrate metabolism regulation. Imbalances in thyroid and iodine metabolism can negatively affect these vital functions. Pregnant women are at risk of hypo or hyperthyroidism, in relation to or regardless of their medical history, with potential dramatic outcomes. Fetal development highly relies on thyroid and iodine metabolism and can be compromised if they malfunction. As the interface between the fetus and the mother, the placenta plays a crucial role in thyroid and iodine metabolism during pregnancy. This narrative review aims to provide an update on current knowledge of thyroid and iodine metabolism in normal and pathological pregnancies. After a brief description of general thyroid and iodine metabolism, their main modifications during normal pregnancies and the placental molecular actors are described. We then discuss the most frequent pathologies to illustrate the upmost importance of iodine and thyroid for both the mother and the fetus.

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Section: Maternal Pathologies During Pregnancymentioning

confidence: 99%

Iodine and Thyroid Maternal and Fetal Metabolism during Pregnancy

2023

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“…In addition, the use of b-blockers is mostly well tolerated during the postpartum period to prevent life-threatening manifestations. It is also important to note that b-blockers are secreted in breast milk, but hypoglycemia and bradycardia may occur in breastfed infants, albeit rarely ( 19 ). Therefore, dose adjustment of beta-blockers may be needed and postpartum care remains the same as in routine cases ( 20 ).…”

Section: Pregnancy Post-partum and Perimenopausal Periodsmentioning

confidence: 99%

Sex differences in long QT syndrome

Díez-Escuté

Arbelo

Martínez-Barrios

et al. 2023

Front. Cardiovasc. Med.

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Long QT Syndrome (LQTS) is a rare, inherited channelopathy characterized by cardiac repolarization dysfunction, leading to a prolonged rate-corrected QT interval in patients who are at risk for malignant ventricular tachyarrhythmias, syncope, and even sudden cardiac death. A complex genetic origin, variable expressivity as well as incomplete penetrance make the diagnosis a clinical challenge. In the last 10 years, there has been a continuous improvement in diagnostic and personalized treatment options. Therefore, several factors such as sex, age diagnosis, QTc interval, and genetic background may contribute to risk stratification of patients, but it still currently remains as a main challenge in LQTS. It is widely accepted that sex is a risk factor itself for some arrhythmias. Female sex has been suggested as a risk factor in the development of malignant arrhythmias associated with LQTS. The existing differences between the sexes are only manifested after puberty, being the hormones the main inducers of arrhythmias. Despite the increased risk in females, no more than 10% of the available publications on LQTS include sex-related data concerning the risk of malignant arrhythmias in females. Therein, the relevance of our review data update concerning women and LQTS.

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“…Hypoglycemia, and especially prolonged hypoglycemia, can cause severe brain injury in neonates [ 48 , 49 ]. Therefore, it is important to know whether exposure to beta-blockers in utero or through lactation substantially increases the risk for bradycardia and hypoglycemia in neonates and to what extent [ 50 ].…”

Section: Reviewmentioning

confidence: 99%

“…Beta-blockers are used to treat multiple diseases in lactating women. They can pass into breast milk and harmfully affect the neonate, causing hypoglycemia and bradycardia [ 50 ]. Beta-blockers inhibit beta-1 and beta-2 receptors.…”

Section: Reviewmentioning

confidence: 99%

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Beta-Blockers and Their Current Role in Maternal and Neonatal Health: A Narrative Review of the Literature

Martinez,

Lakkimsetti,

Maharjan

et al. 2023

Cureus

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Beta-blockers are a class of medications that act on beta-adrenergic receptors and are categorized as cardio-selective and non-selective. They are principally used to treat cardiovascular conditions such as hypertension and arrhythmias. Beta-blockers have also been used to treat non-cardiogenic indications in non-pregnant individuals and the pediatric population. In pregnancy, labetalol is the mainstay treatment for hypertension and other cardiovascular indications. However, contraindications to certain sub-types of beta-blockers include bradycardia, heart failure, obstructive lung diseases, and hemodynamic instability. There is conflicting evidence of the adverse effects on fetal and neonatal health due to a scarce safety and efficacy profile, and further studies are necessary to understand the pharmacokinetics of the different classes of beta-blockers in pregnancy and fetal health. Understanding the hemodynamic changes during the stages of pregnancy is important to target a more beneficial therapy for both mother and fetus as well as better neonatal outcomes. Beta-blocker use in the pediatric population is less documented in studies but does have the potential to treat various cardiogenic and non-cardiogenic conditions. Future comprehensive studies would further benefit the direction of beta-blocker treatment during pregnancy in neonates and pediatrics.

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Risk for neonatal hypoglycaemia and bradycardia after beta-blocker use during pregnancy or lactation: a systematic review and meta-analysis protocol

Cited by 4 publications

References 14 publications

Iodine and Thyroid Maternal and Fetal Metabolism during Pregnancy

Iodine and Thyroid Maternal and Fetal Metabolism during Pregnancy

Sex differences in long QT syndrome

Beta-Blockers and Their Current Role in Maternal and Neonatal Health: A Narrative Review of the Literature

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