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Antihypertensive drug therapy for mild to moderate hypertension during pregnancy

  1. Edgardo Abalos1,*,
  2. Lelia Duley2,
  3. D Wilhelm Steyn3

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 6 FEB 2014

Assessed as up-to-date: 30 APR 2013

DOI: 10.1002/14651858.CD002252.pub3


How to Cite

Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD002252. DOI: 10.1002/14651858.CD002252.pub3.

Author Information

  1. 1

    Centro Rosarino de Estudios Perinatales (CREP), Rosario, Santa Fe, Argentina

  2. 2

    Nottingham Health Science Partners, Nottingham Clinical Trials Unit, Nottingham, UK

  3. 3

    University of Stellenbosch, Obstetrics & Gynaecology, Tygerberg, Stellenbosch, South Africa

*Edgardo Abalos, Centro Rosarino de Estudios Perinatales (CREP), Moreno 878, 6th floor, Rosario, Santa Fe, S2000DKR, Argentina. edgardoabalos@crep.org.ar. crep@crep.org.ar.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 6 FEB 2014

SEARCH

[Figure 1]
Figure 1. 'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 2]
Figure 2. 'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
[Figure 3]
Figure 3. Funnel plot of comparison: 1 Any antihypertensive drug versus none (subgrouped by class of drug), outcome: 1.4 Proteinuria/pre-eclampsia.
[Figure 4]
Figure 4. Funnel plot of comparison: 2 Any antihypertensive drug versus none (subgrouped by type of hypertensive disorder at trial entry), outcome: 2.2 Proteinuria/pre-eclampsia.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 1 Maternal death.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 2 Eclampsia.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 3 Severe hypertension.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 4 Proteinuria/pre-eclampsia.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 5 Severe pre-eclampsia.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 6 HELLP syndrome.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 7 Pulmonary oedema.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 8 Additional antihypertensive.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 9 Changed/stopped drugs due to maternal side-effects.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 10 Maternal side-effects.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 11 Antenatal hospital admission.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 12 Induction of labour.
[Analysis 1.13]
Analysis 1.13. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 13 Elective delivery (induction of labour + elective caesarean section).
[Analysis 1.14]
Analysis 1.14. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 14 Caesarean section.
[Analysis 1.15]
Analysis 1.15. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 15 Placental abruption.
[Analysis 1.16]
Analysis 1.16. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 16 Total reported fetal or neonatal death (including miscarriage).
[Analysis 1.17]
Analysis 1.17. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 17 Fetal or neonatal death (subgrouped by time of death).
[Analysis 1.18]
Analysis 1.18. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 18 Preterm birth (< 37 weeks).
[Analysis 1.19]
Analysis 1.19. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 19 Preterm birth (subgrouped by gestational age).
[Analysis 1.20]
Analysis 1.20. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 20 Small-for-gestational age.
[Analysis 1.21]
Analysis 1.21. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 21 Small-for-gestational age (subgrouped by severity).
[Analysis 1.22]
Analysis 1.22. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 22 Admission to special care baby unit.
[Analysis 1.23]
Analysis 1.23. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 23 Respiratory distress syndrome.
[Analysis 1.24]
Analysis 1.24. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 24 Neonatal hypoglycaemia.
[Analysis 1.25]
Analysis 1.25. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 25 Neonatal bradycardia.
[Analysis 1.26]
Analysis 1.26. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 26 Neonatal jaundice.
[Analysis 1.27]
Analysis 1.27. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 27 Follow-up of the children at 1 year: cerebral palsy.
[Analysis 1.28]
Analysis 1.28. Comparison 1 Any antihypertensive drug versus none (subgrouped by class of drug), Outcome 28 Follow-up of the children at 7 1/2 years.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Any antihypertensive drug versus none (subgrouped by type of hypertensive disorder at trial entry), Outcome 1 Severe hypertension.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Any antihypertensive drug versus none (subgrouped by type of hypertensive disorder at trial entry), Outcome 2 Proteinuria/pre-eclampsia.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Any antihypertensive drug versus none (subgrouped by type of hypertensive disorder at trial entry), Outcome 3 Total reported fetal or neonatal death (including miscarriage).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Any antihypertensive drug versus none (subgrouped by type of hypertensive disorder at trial entry), Outcome 4 Preterm birth (< 37 weeks).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Any antihypertensive drug versus none (subgrouped by type of hypertensive disorder at trial entry), Outcome 5 Small-for-gestational age.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Any antihypertensive drug versus none (subgrouped by gestation at trial entry), Outcome 1 Severe hypertension.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Any antihypertensive drug versus none (subgrouped by gestation at trial entry), Outcome 2 Proteinuria/pre-eclampsia.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Any antihypertensive drug versus none (subgrouped by gestation at trial entry), Outcome 3 Total reported fetal or neonatal death (including miscarriage).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Any antihypertensive drug versus none (subgrouped by gestation at trial entry), Outcome 4 Preterm birth (< 37 weeks).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Any antihypertensive drug versus none (subgrouped by gestation at trial entry), Outcome 5 Small-for-gestational age.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Any antihypertensive drug versus none (subgrouped by use of placebo), Outcome 1 Severe hypertension.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Any antihypertensive drug versus none (subgrouped by use of placebo), Outcome 2 Proteinuria/pre-eclampsia.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Any antihypertensive drug versus none (subgrouped by use of placebo), Outcome 3 Total reported fetal or neonatal death (including miscarriage).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Any antihypertensive drug versus none (subgrouped by use of placebo), Outcome 4 Preterm birth (< 37 weeks).
[Analysis 4.5]
Analysis 4.5. Comparison 4 Any antihypertensive drug versus none (subgrouped by use of placebo), Outcome 5 Small-for-gestational age.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 1 Severe hypertension.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 2 Proteinuria/pre-eclampsia.
[Analysis 5.3]
Analysis 5.3. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 3 Additional antihypertensive.
[Analysis 5.4]
Analysis 5.4. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 4 Antenatal hospital admission.
[Analysis 5.5]
Analysis 5.5. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 5 Elective delivery (induction of labour + elective caesarean section).
[Analysis 5.6]
Analysis 5.6. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 6 Caesarean section.
[Analysis 5.7]
Analysis 5.7. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 7 Maternal side-effects.
[Analysis 5.8]
Analysis 5.8. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 8 Changed/stopped drugs due to maternal side-effects.
[Analysis 5.9]
Analysis 5.9. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 9 Placental abruption.
[Analysis 5.10]
Analysis 5.10. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 10 Total reported fetal or neonatal death (including miscarriage).
[Analysis 5.11]
Analysis 5.11. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 11 Preterm birth (< 37 weeks).
[Analysis 5.12]
Analysis 5.12. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 12 Small-for-gestational age.
[Analysis 5.13]
Analysis 5.13. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 13 Admission to special care baby unit.
[Analysis 5.14]
Analysis 5.14. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 14 Neonatal hypoglycaemia.
[Analysis 5.15]
Analysis 5.15. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 15 Neonatal bradycardia.
[Analysis 5.16]
Analysis 5.16. Comparison 5 Any antihypertensive versus methyldopa (subgrouped by class of drug), Outcome 16 Neonatal jaundice.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 1 Severe hypertension.
[Analysis 6.2]
Analysis 6.2. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 2 Proteinuria/pre-eclampsia.
[Analysis 6.3]
Analysis 6.3. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 3 HELLP syndrome.
[Analysis 6.4]
Analysis 6.4. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 4 Additional antihypertensive.
[Analysis 6.5]
Analysis 6.5. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 5 Changed/stopped drug due to side-effects.
[Analysis 6.6]
Analysis 6.6. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 6 Maternal side-effects.
[Analysis 6.7]
Analysis 6.7. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 7 Elective delivery (induction of labour + elective caesarean section).
[Analysis 6.8]
Analysis 6.8. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 8 Caesarean section.
[Analysis 6.9]
Analysis 6.9. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 9 Placental abruption.
[Analysis 6.10]
Analysis 6.10. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 10 Total reported fetal or neonatal death (including miscarriage).
[Analysis 6.11]
Analysis 6.11. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 11 Preterm birth (< 37 weeks).
[Analysis 6.12]
Analysis 6.12. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 12 Small-for-gestational age.
[Analysis 6.13]
Analysis 6.13. Comparison 6 Any antihypertensive versus calcium channel blocker (subgrouped by class of drug), Outcome 13 Admission to special care baby unit.