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

https://doi.org/10.1136/ebm.5.5.141

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    (2000) Lancet 355, 87. von Dadelszen P, Ornstein MP, Bull SB, et al. . Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: a meta-analysis. . . Jan 8;. :. –92..
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 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 …

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    Footnotes

    • Source of funding: Physicians' Services Incorporated and Mount Sinai Hospital, Toronto.

    • For correspondence: Dr L A Magee, 600 University Avenue, Suite 428, Toronto, Ontario M5G 1X5, Canada. Fax +1 416 586 8434.