Outpatient calcium-channel blockers and the risk of postpartum haemorrhage: a cohort study
Article first published online: 11 SEP 2013
© 2013 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 13, pages 1668–1677, December 2013
How to Cite
Outpatient calcium-channel blockers and the risk of postpartum haemorrhage: a cohort study. BJOG 2013; DOI: 10.1111/1471-0528.12428., , , , , , , .
- Issue published online: 11 NOV 2013
- Article first published online: 11 SEP 2013
- Manuscript Accepted: 19 JUN 2013
- National Institutes of Health. Grant Numbers: T32 GM007592, K24 HL096141
- Agency for Healthcare Research and Quality (AHRQ). Grant Number: R01HS018533
- Training Grant. Grant Number: T32HD060454
- Calcium-channel blockers;
- hypertensive disorders of pregnancy;
- postpartum haemorrhage
To determine whether outpatient exposure to calcium-channel blockers (CCBs) at the time of delivery is associated with an increased risk for postpartum haemorrhage (PPH).
United States of America.
Population or sample
We identified a cohort of 9750 patients with outpatient prescriptions for CCBs, methyldopa, or labetalol for pre-existing or gestational hypertension whose days of supply overlapped with delivery; 1226 were exposed to CCBs. The risk of PPH was compared in those exposed to CCBs to those exposed to methyldopa or labetalol. Propensity score matching and stratification were used to address potential confounding.
Main outcome measures
The occurrence of PPH during the delivery hospitalisation.
There were 27 patients exposed to CCBs (2.2%) and 232 patients exposed to methyldopa or labetalol (2.7%) who experienced PPH. After accounting for confounders, there was no meaningful association between CCB exposure and PPH in the propensity score matched (odds ratio 0.77, 95% CI 0.50–1.18) or stratified (odds ratio 0.79, 95% CI 0.53–1.19) analyses. Similar results were obtained across multiple sensitivity analyses.
The outpatient use of CCBs in late pregnancy for the treatment of hypertension does not increase the risk of PPH.