Neurocognitive development of children following in-utero exposure to labetalol for maternal hypertension: a cohort study using a prospectively collected database.
OBJECTIVE
To identify the effect of prenatal labetalol exposure on children's long-term neurodevelopment.


METHODS
A cohort study with matched controls using a prospectively collected database.


METHODS
Participants were women counseled for hypertension in pregnancy at the Motherisk Program at The Hospital for Sick Children, and The Sunnybrook Health Sciences Centre, Toronto, Canada and their children. Mother-child pairs were divided into groups based on in-utero exposure to labetalol (n = 32), non-teratogenic substances (n = 42), and methyldopa (n = 25). The main outcome measures were children's Full-Scale IQ, Performance IQ and Verbal IQ assessed with the Wechsler Preschool and Primary Scale of Intelligence.


RESULTS
There were no statistically significant differences in scores on Full-Scale IQ, Performance IQ, or Verbal IQ between children exposed in utero to labetalol and to non-teratogenic substances (Full-Scale IQ: 109.60 +/- 8.20 vs. 111.90 +/- 11.39, p = 0.647; Performance IQ: 104.80 +/- 8.69 vs. 110.19 +/- 12.91, p = 0.186; Verbal IQ: 112.27 +/- 11.05 vs. 11.21 +/- 11.98, p = 0.922, respectively). Children in the methyldopa group achieved lower scores on measures of Full-Scale IQ and Performance IQ when compared to children exposed to non-teratogenic substances (Full-Scale IQ: 105.24 +/- 12.46 vs. 111.90 +/- 11.39, p = 0.043; Performance IQ: 98.80 +/- 16.16 vs. 110.19 +/- 12.91, p = 0.002, respectively). Linear regression analysis revealed that maternal Full Scale IQ was a significant predictor of children's Full-Scale IQ (p = 0.020, beta = 0.229). Maternal Performance IQ and duration of treatment with methyldopa were significant predictors of children's Performance IQ (p = 0.028, beta = 0.232; p = 0.16, beta = -0.255, respectively).


CONCLUSIONS
In-utero exposure to labetalol does not appear to adversely affect the neurocognitive development of young children. These reassuring results may aid disease management for pregnant women with hypertension.
Chan
Wee Shian
WS
Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.
Koren
Gideon
G
Barrera
Maru
M
Rezvani
Massoud
M
Knittel-Keren
Dafna
D
Nulman
Irena
I
D000328:Adult; D000704:Analysis of Variance; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007360:Intelligence / Q000187:drug effects*; D007361:Intelligence Tests; D007741:Labetalol / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D007741:Labetalol