Effect of labetalol for mild to moderate hypertension during pregnancy on maternal and fetal outcomes: a meta-analysis / 中华围产医学杂志

ABSTRACT

Objective To review outcomes in randomized controlled trials comparing labetalol with other anti hypertensives/placebo/no drug for mild to moderate hypertension in pregnancy.Methods We searched PubMed,China Knowledge Resource Integrated Database and VIP Database and performed a meta analysis of randomized controlled trials of labetalol for hypertension in pregnancy.Data were entered into RevMan software for analysis [relative risk (RR) and its 95％ confidence interval (CI)].Results Seven studies were included in the meta-analysis.Four trials (553 women) compared labetalol with methyldopa for mild to moderate hypertension in pregnancy.Labetalol reduced the risk of severe hypertension (RR=0.52,95％CI0.31-0.88) and proteinuria (RR=0.57,95％CI0.36 0.91).The incidence of preterm birth and small-for-gestational-age infants was similar between these two groups.Five trials (720 women) compared labetalol with placebo/no drug for mild to moderate hypertension in pregnancy.Labetalol reduced the risk of severe hypertension (RR=0.29,95％CI0.16-0.53) and proteinuria (RR-0.73,95％CI0.56-0.95) and showed no effect on preterm birth and small-for-gestational-age infants.Conclusions The results support the use of labetalol for mild to moderate hypertension in pregnancy.Labetalol is more effective in treating hypertension than methyldopa.However,due to the quality of the included studies,clinical effects of labetalol need to be evaluated in high quality randomized controlled trials.