β-blockers Appear Safe in Pregnant Patients with HTN

Written by Clay Smith

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β-blockers appear safe to use in hypertensive pregnant patients in the first trimester.

Why does this matter?
β-blockers are commonly used to treat hypertension in pregnancy. Yet, there has been some concern about these drugs being teratogenic. So, are they?

Seems safe to β-block in pregnancy
This was a cohort study of 3,577 pregnant hypertensive women in the first trimester from 5 Nordic countries and 14,900 in a U.S. cohort. There were 682 (19.1%) and 1,668 (11.2%) patients with exposure to β-blockers, respectively. They found no increase in any major congenital malformation, adjusted relative risk 1.07 (95% CI, 0.89 to 1.30), nor was there a large increase in risk of cardiac, CNS malformations, or cleft lip/palate in patients taking β-blockers, though the number of patients with CNS and ENT deformities was quite small.

Source
β-Blocker Use in Pregnancy and the Risk for Congenital Malformations: An International Cohort Study. Ann Intern Med. 2018 Oct 16. doi: 10.7326/M18-0338. [Epub ahead of print]

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