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Is use of multiple antihypertensive agents to achieve blood pressure control associated with adverse pregnancy outcomes?

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Abstract

Objective:

We assessed whether requiring >1 medication for blood pressure control is associated with adverse pregnancy outcomes.

Study Design:

Retrospective cohort of 974 singletons with chronic hypertension at a tertiary care center. Subjects on >1 antihypertensive agent were compared with those on one agent <20 weeks gestational age with results stratified by average blood pressure (<140/90 and ⩾140/90 mm Hg) from prenatal visits. The primary maternal outcome was preeclampsia; the primary neonatal outcome was small for gestational age (<10th percentile).

Result:

Among women with blood pressure ⩾140/90 mm Hg, women on multiple agents had the greatest risk of preeclampsia, severe preeclampsia, antenatal admissions to rule out preeclampsia, preterm birth <35 weeks and composite neonatal adverse outcomes.

Conclusion:

Compared with use of a single agent when blood pressure is ⩾140/90 mm Hg, use of multiple agents increases adverse risks, while no such finding exists when blood pressure is controlled below 140/90 mm Hg.

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Acknowledgements

LMH is supported by K12HD001258 (PI WW Andrews, NICHD), which partially supports this work.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL, USA

    S E Allen, A Tita, S Anderson, J R Biggio & Dr L M Harper

Authors
  1. S E Allen
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  2. A Tita
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  3. S Anderson
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  4. J R Biggio
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  5. Dr L M Harper
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Corresponding author

Correspondence to Dr L M Harper.

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The authors declare no conflict of interest.

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Allen, S., Tita, A., Anderson, S. et al. Is use of multiple antihypertensive agents to achieve blood pressure control associated with adverse pregnancy outcomes?. J Perinatol 37, 340–344 (2017). https://doi.org/10.1038/jp.2016.247

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  • DOI: https://doi.org/10.1038/jp.2016.247

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