β-Blocker Use in Pregnancy and the Risk for Congenital Malformations
Authors: Alena Shantsila, D. Gareth Beevers, Gregory Y.H. Lip
Journal: Annals of Internal Medicine (2019)

Letters18 June 2019β-Blocker Use in Pregnancy and the Risk for Congenital MalformationsAlena Shantsila, PhD, D. Gareth Beevers, MD, and Gregory Y.H. Lip, MDAlena Shantsila, PhDUniversity of Liverpool, Liverpool, United Kingdom (A.S., G.Y.L.)Search for more papers by this author, D. Gareth Beevers, MDUniversity of Birmingham, Birmingham, United Kingdom (D.G.B.)Search for more papers by this author, and Gregory Y.H. Lip, MDUniversity of Liverpool, Liverpool, United Kingdom (A.S., G.Y.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0156 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Bateman and colleagues' article (1) with interest. Hypertension during pregnancy is common and is a major cause of maternal and perinatal mortality. It includes cases of high blood pressure that require pharmacologic treatment in the first trimester. Use of medicines during this part of pregnancy is particularly concerning, because it may affect organogenesis and thus cause severe fetal abnormalities.Bateman and colleagues report that treating hypertension with β-blockers in the first trimester has not been associated with an increased risk for overall or cardiac congenital malformations (1). Their findings were confirmed after adjustment for many ...References1. Bateman BT, Heide-Jørgensen U, Einarsdóttir K, et al. ß-Blocker use in pregnancy and the risk for congenital malformations: an international cohort study. Ann Intern Med. 2018;169:665-73. [PMID: 30326014]. doi:10.7326/M18-0338 LinkGoogle Scholar2. Lip GY, Beevers M, Churchill D, et al. Effect of atenolol on birth weight. Am J Cardiol. 1997;79:1436-8. [PMID: 9165181] CrossrefMedlineGoogle Scholar3. Lydakis C, Lip GY, Beevers M, et al. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens. 1999;12:541-7. [PMID: 10371362] CrossrefMedlineGoogle Scholar4. Xie RH, Guo Y, Krewski D, et al. Association between labetalol use for hypertension in pregnancy and adverse infant outcomes. Eur J Obstet Gynecol Reprod Biol. 2014;175:124-8. [PMID: 24502872] doi:10.1016/j.ejogrb.2014.01.019 CrossrefMedlineGoogle Scholar5. Fitton CA, Steiner MFC, Aucott L, et al. In-utero exposure to antihypertensive medication and neonatal and child health outcomes: a systematic review. J Hypertens. 2017;35:2123-37. [PMID: 28661961] doi:10.1097/HJH.0000000000001456 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Liverpool, Liverpool, United Kingdom (A.S., G.Y.L.)University of Birmingham, Birmingham, United Kingdom (D.G.B.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0156. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee Alsoβ-Blocker Use in Pregnancy and the Risk for Congenital Malformations Brian T. Bateman , Uffe Heide-Jørgensen , Kristjana Einarsdóttir , Anders Engeland , Kari Furu , Mika Gissler , Sonia Hernandez-Diaz , Helle Kieler , Anna-Maria Lahesmaa-Korpinen , Helen Mogun , Mette Nørgaard , Johan Reutfors , Randi Selmer , Krista F. Huybrechts , and Helga Zoega β-Blocker Use in Pregnancy and the Risk for Congenital Malformations Brian T. Bateman , Krista F. Huybrechts , Sonia Hernandez-Diaz , Helle Kieler , and Helga Zoega Metrics 18 June 2019Volume 170, Issue 12Page: 909KeywordsDisclosureHypertensionPharmacokineticsPregnancyPrimary hypertensionRespiratory distress syndromeRisk managementSepsisStable coronary artery diseaseSystematic reviews ePublished: 18 June 2019 Issue Published: 18 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...