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Evid Based Med 5:141 doi:10.1136/ebm.5.5.141
  • Therapeutics

Review: treatment induced blood pressure reductions in pregnancy may be associated with decreased fetal growth


 
 QUESTION: In pregnant women with mild to moderate hypertension, is treatment with oral antihypertensive medication associated with impaired fetoplacental growth?

Data sources

Randomised controlled trials were identified by searching Medline (1966–97) with the terms antihypertensive agents; bed rest; hospitalization; plasma volume expansion; plasma substitutes; maternal mortality; pregnancy; pregnancy complications; perinatology; neonatology; infant, newborn diseases; infant; and infant mortality. 1 journal was handsearched, and bibliographies of relevant studies were scanned.

Study selection

English and French language studies were selected if they included pregnant women with mild to moderate hypertension, oral antihypertensive medications were compared with each other or placebo, and outcomes of blood pressure changes and fetal growth were reported.

Data extraction

Data were extracted in duplicate on study quality; antihypertensive medications studied, including duration and dose; maternal hypertension (chronic or late onset during pregnancy); change in blood pressure, defined as change in mean arterial pressure (MAP), which was calculated by …