Open AccessBeta‐blocker subtypes and risk of low birth weight in newborns
Author(s) -
Duan Lewei,
Ng Angie,
Chen Wansu,
Spencer Hillard T.,
Lee MingSum
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13397
Subject(s) - atenolol , labetalol , medicine , metoprolol , propranolol , birth weight , beta blocker , gestational age , cohort , obstetrics , pregnancy , blood pressure , heart failure , biology , genetics
Beta‐blockers are one of the most commonly prescribed classes of antihypertensive medications during pregnancy. Previous studies reported an association between beta‐blocker exposure and intrauterine growth restriction. Whether some beta‐blocker subtypes may be associated with higher risk is not known. This is a retrospective cohort study of pregnant women exposed to beta‐blockers in the Kaiser Permanente Southern California Region between 2003 and 2014. Logistic regression models were used to evaluate association between exposure to different beta‐blocker agents and risk of low fetal birth weights. In a cohort of 379 238 singleton pregnancies, 4847 (1.3%) were exposed to beta‐blockers. The four most commonly prescribed beta‐blockers were labetalol (n = 3357), atenolol (n = 638), propranolol (n = 489), and metoprolol (n = 324). Mean birth weight and % low birth weight (<2500 g) were 2926 ± 841 g and 24.4% for labetalol, 3058 ± 748 g and 18.0% for atenolol, 3163 ± 702 g and 13.3% for metoprolol, 3286 ± 651 g and 7.6% for propranolol, and 3353 ± 554 g and 5.2% for non‐exposed controls. Exposure to atenolol and labetalol were associated with increased risks of infant born small for gestational age (SGA) (atenolol: adjusted OR 2.4, 95% CI: 1.7‐3.3; labetalol: adjusted OR 2.9, 95% CI: 2.6‐3.2). Risk of SGA associated with metoprolol or propranolol exposure was not significantly different from the non‐exposed group (metoprolol: adjusted OR 1.5, 95% CI: 0.9‐2.3; propranolol: adjusted OR 1.3, 95% CI: 0.9‐1.9). Association between beta‐blocker exposure and SGA does not appear to be a class effect. Variations in pharmacodynamics and confounding by indication may explain these findings.