title: Control of Hypertension In Pregnancy Study randomised controlled trial-are the results dependent on the choice of labetalol or methyldopa?
abstract: OBJECTIVE
  To determine whether the difference in outcomes between 'less tight' (target diastolic blood pressure [dBP] of 100 mmHg) versus 'tight' control (target dBP of 85 mmHg) in the CHIPS Trial (ISRCTN 71416914, http://pre-empt.cfri.ca/;CHIPS) depended on the choice of labetalol or methyldopa, the two most commonly used antihypertensive agents in CHIPS.
  
  
  METHODS
  Secondary analysis of CHIPS Trial data.
  
  
  METHODS
  International multicentre randomised controlled trial (94 sites, 15 countries).
  
  
  METHODS
  A total of 987 women with non-severe non-proteinuric pregnancy hypertension.
  
  
  METHODS
  Logistic regression was used for comparisons of 'less tight' versus 'tight' control among women treated with labetalol (but not methydopa) versus methyldopa (but not labetalol). Analyses were adjusted for the influence of baseline factors, including use of any antihypertensive therapy at randomisation.
  
  
  METHODS
  Main CHIPS Trial outcomes: primary (perinatal loss or high-level neonatal care for > 48 hours), secondary (serious maternal complications), birthweight < 10th centile, severe maternal hypertension, pre-eclampsia, and delivery at < 34 or < 37 weeks.
  
  
  RESULTS
  Of 987 women in CHIPS, antihypertensive therapy was taken by 566 women at randomisation (labetalol 111 ['less tight'] versus 127 ['tight'] or methyldopa 126 ['less tight'] versus 117 ['tight']) and 815 women after randomisation (labetalol 186 ['less tight'] versus 247 ['tight'] and methyldopa by 98 ['less tight'] versus 126 ['tight']). Following adjustment, odds ratios for outcomes in 'less tight' versus 'tight' control were similar between antihypertensive groups according to 'at randomisation' and 'after randomisation' therapy.
  
  
  CONCLUSIONS
  Outcomes for 'less tight' versus 'tight' control were not dependent on use of methyldopa or labetalol.
  
  
  CONCLUSIONS
  In the CHIPS Trial, maternal and infant outcomes were not dependent on use of labetalol or methyldopa.
authors.affiliation: Medicine, University of British Columbia, Vancouver, BC, Canada.|Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: L A
authors.initials: LA
authors.lastname: Magee
authors.affiliation: Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: von Dadelszen
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.|Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Care Research Institute, UBC, Vancouver, BC, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Singer
authors.affiliation: Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Care Research Institute, UBC, Vancouver, BC, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Lee
authors.affiliation: Medicine and Obstetrics and Gynaecology, University of Montreal, Montreal, QC, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Rey
authors.affiliation: Obstetrics and Gynaecology, University of Alberta, Edmonton, AB, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Ross
authors.affiliation: Paediatrics, University of Toronto, Toronto, ON, Canada.|Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.|The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Asztalos
authors.affiliation: Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.|The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
authors.forename: K E
authors.initials: KE
authors.lastname: Murphy
authors.affiliation: Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Menzies
authors.affiliation: The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Sanchez
authors.affiliation: Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Gafni
authors.affiliation: Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Gruslin
authors.affiliation: Obstetrics and Gynaecology, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Helewa
authors.affiliation: Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Hutton
authors.affiliation: Paediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Koren
authors.affiliation: Paediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: A G
authors.initials: AG
authors.lastname: Logan
authors.affiliation: Obstetrics and Gynaecology, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Ganzevoort
authors.affiliation: Obstetrics and Gynaecology, Derriford Hospital, Plymouth, UK.
authors.forename: R
authors.initials: R
authors.lastname: Welch
authors.affiliation: Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Thornton
authors.affiliation: Obstetrics and Gynaecology, Universite de Sherbrooke, Sherbrooke, QC, Canada.
authors.forename: J-M
authors.initials: JM
authors.lastname: Moutquin
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy* / Q000503:physiopathology; D007230:Infant, Low Birth Weight; D007741:Labetalol / Q000627:therapeutic use*; D008750:Methyldopa / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy / Q000503:physiopathology; D047928:Premature Birth / Q000209:etiology; D011295:Prenatal Care / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D008750:Methyldopa; D007741:Labetalol
keywords: Antihypertensive therapy; hypertension; labetalol; methyldopa; pregnancy