Neonatal effects of intrauterine metoprolol/bisoprolol exposure during the second and third trimester: a cohort study with two comparison groups
| Autor: | Maria Hoeltzenbein, Evelin Beck, Sandra Zinke, Angela Kayser, Corinna Weber-Schoendorfer, Christof Schaefer, Reinhard Meister |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Physiology Pregnancy Trimester Third Birth weight Adrenergic beta-Antagonists 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors Internal Medicine Birth Weight Bisoprolol Humans Medicine 030212 general & internal medicine Antihypertensive Agents business.industry Obstetrics Infant Newborn Infant Odds ratio medicine.disease Pregnancy Trimester Second Prenatal Exposure Delayed Effects Hypertension Infant Small for Gestational Age Cohort Premature Birth Gestation Small for gestational age Female Cardiology and Cardiovascular Medicine business Metoprolol Cohort study medicine.drug |
| Zdroj: | Journal of Hypertension. 38:354-361 |
| ISSN: | 1473-5598 0263-6352 |
| DOI: | 10.1097/hjh.0000000000002256 |
| Popis: | Objectives Our aim was to evaluate the effects of beta-blockers during the second and third trimester on fetal growth, length of gestation and postnatal symptoms in exposed infants. Methods The current prospective observational cohort study compares 294 neonates of hypertensive mothers on metoprolol or bisoprolol during the second and/or third trimester with 225 methyldopa-exposed infants and 588 infants of nonhypertensive mothers. The risks for reduced birth weight, prematurity, neonatal bradycardia, hypoglycaemia and respiratory disorders were analysed. Results The rate of small-for-gestational-age children was significantly higher in long-term beta-blocker exposed infants (24.1%) compared with the methyldopa cohort [10.2%, odds ratio (OR)adj 2.5, 95% confidence interval (CI) 1.2-5.2] and the nonhypertensive cohort (9.9%, ORadj 4.3, 95% CI 2.6-7.1). The risk for preterm birth was significantly increased compared with nonhypertensive pregnancies (ORadj 2.2, 95% CI 1.3-3.8) but not compared with the methyldopa cohort. Neonatal adverse outcomes occurred more frequently in the study cohort (11.5%) compared with the nonhypertensive comparison group (6.5%) and the methyldopa cohort (8.4%), but without statistical significance (ORadj 1.5, 95% CI 0.7-3.0 and ORadj 1.5, 95% CI 0.7-3.3, respectively). Conclusion Long-term intrauterine exposure to metoprolol or bisoprolol may increase the risk of being born small-for-gestational-age. It is still a matter of debate to which extent maternal hypertension contributes to the lower birth weight. Serious neonatal symptoms are rare. Altogether, metoprolol and bisoprolol are well tolerated treatment options, but a case-by-case decision on close neonatal monitoring is recommended. |
| Databáze: | OpenAIRE |
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