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Outpatient calcium‐channel blockers and the risk of postpartum haemorrhage: a cohort study
Author(s) -
Bateman BT,
HernandezDiaz S,
Huybrechts KF,
Palmsten K,
Mogun H,
Ecker JL,
Seely EW,
Fischer MA
Publication year - 2013
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12428
Subject(s) - medicine , propensity score matching , odds ratio , labetalol , cohort , pregnancy , confounding , gestational hypertension , cohort study , preeclampsia , obstetrics , blood pressure , genetics , biology
Objective To determine whether outpatient exposure to calcium‐channel blockers ( CCB s) at the time of delivery is associated with an increased risk for postpartum haemorrhage ( PPH ). Design Cohort study. Setting United States of America. Population or sample Medicaid beneficiaries. Methods We identified a cohort of 9750 patients with outpatient prescriptions for CCB s, methyldopa, or labetalol for pre‐existing or gestational hypertension whose days of supply overlapped with delivery; 1226 were exposed to CCB s. The risk of PPH was compared in those exposed to CCB s to those exposed to methyldopa or labetalol. Propensity score matching and stratification were used to address potential confounding. Main outcome measures The occurrence of PPH during the delivery hospitalisation. Results There were 27 patients exposed to CCB s (2.2%) and 232 patients exposed to methyldopa or labetalol (2.7%) who experienced PPH . After accounting for confounders, there was no meaningful association between CCB exposure and PPH in the propensity score matched (odds ratio 0.77, 95% CI 0.50–1.18) or stratified (odds ratio 0.79, 95% CI 0.53–1.19) analyses. Similar results were obtained across multiple sensitivity analyses. Conclusions The outpatient use of CCB s in late pregnancy for the treatment of hypertension does not increase the risk of PPH .