title: Beta-blockers increase the risk of being born small for gestational age or of being institutionalised during infancy.
abstract: OBJECTIVE
  To compare infant outcomes between mothers with hypertension treated by beta-blockers alone and by methyldopa alone during pregnancy.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Saskatchewan, Canada.
  
  
  METHODS
  Women who delivered a singleton birth in Saskatchewan during the periods from 1 January 1980 to 30 June 1987 or from 1 January 1990 to 31 December 2005 (women who delivered between 1 July 1987 and 31 December 1989 were excluded because the information recorded on maternal drug use during pregnancy is incomplete) with a diagnosis of a hypertensive disorder during pregnancy, and who were dispensed only beta-blockers (n = 416) or only methyldopa (n = 1000).
  
  
  METHODS
  Occurrences of adverse infant outcomes were compared between women who received beta-blockers only and women who received methyldopa only during pregnancy, first in all eligible women, and then in women with chronic hypertension and in women with gestational hypertension or pre-eclampsia/eclampsia, separately. Multiple logistic regression analyses were performed to adjust for potential confounding.
  
  
  METHODS
  Small for gestational age (SGA) < 10th percentile, SGA < 3rd percentile, preterm birth, stillbirth, institutionalisation for respiratory distress syndrome (RDS), sepsis, seizure during infancy, and infant death.
  
  
  RESULTS
  Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for infants born to mothers with chronic hypertension who were dispensed beta-blockers only, as compared with infants born to mothers who were dispensed methyldopa only, during pregnancy were: 1.95 (1.21-3.15), 2.17 (1.06-4.44), and 2.17 (1.09-4.34), respectively, for SGA < 10th percentile, SGA < 3rd percentile, and being institutionalised during infancy.
  
  
  CONCLUSIONS
  For infants born to mothers with chronic hypertension, compared with those treated by methyldopa alone, those treated by beta-blockers appear to be at increased rates of SGA and hospitalisation during infancy.
authors.affiliation: Department of Obstetrics and Gynaecology, Nanfang Hospital, Southern Medical University, Guangzhou, China; OMNI Research Group, Department of Obstetrics and Gynaecology, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
authors.forename: R-h
authors.initials: RH
authors.lastname: Xie
authors.forename: Y
authors.initials: Y
authors.lastname: Guo
authors.forename: D
authors.initials: D
authors.lastname: Krewski
authors.forename: D
authors.initials: D
authors.lastname: Mattison
authors.forename: M C
authors.initials: MC
authors.lastname: Walker
authors.forename: K
authors.initials: K
authors.lastname: Nerenberg
authors.forename: S W
authors.initials: SW
authors.lastname: Wen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy / Q000453:epidemiology*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008750:Methyldopa / Q000009:adverse effects; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012525:Saskatchewan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D008750:Methyldopa
keywords: Adrenergic beta-antagonists; hypertension; infant; institutionalised; small for gestational age