Beta-Blockers and Fetal Growth Restriction in Pregnant Women With Cardiovascular Disease.
BACKGROUND
The effects of β-adrenergic blockers on the fetus are not well understood. We analyzed the maternal and neonatal outcomes of β-adrenergic blocker treatment during pregnancy to identify the risk of fetal growth restriction (FGR).


RESULTS
We retrospectively reviewed 158 pregnancies in women with cardiovascular disease at a single center. Maternal and neonatal outcomes were analyzed in 3 categories: the carvedilol (α/β-adrenergic blocker; α/β group, n=13); β-adrenergic blocker (β group, n=45), and control groups (n=100). Maternal outcome was not significantly different between the groups. FGR occurred in 1 patient (7%) in the α/β group, in 12 (26%) in the β group, and in 3 (3%) in the control group; there was a significant difference between the incidence of FGR between the β group and control group (P<0.05). The β group included propranolol (n=22), metoprolol (n=12), atenolol (n=6), and bisoprolol (n=5), and the individual incidence of FGR with these medications was 36%, 17%, 33%, and 0%, respectively.


CONCLUSIONS
As a group, β-adrenergic blockers were significantly associated with FGR, although the incidence of FGR varied with individual β-blocker. Carvedilol, an α/β-adrenergic blocker, had no association with FGR. More controlled studies are needed to fully establish such associations. (Circ J 2016; 80: 2221-2226).
Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center.
Kayo
K
Tanaka
Hiroaki
H
Tanaka
Chizuko
C
Kamiya
Shinji
S
Katsuragi
Masami
M
Sawada
Mitsuhiro
M
Tsuritani
Masashi
M
Yoshida
Naoko
N
Iwanaga
Jun
J
Yoshimatsu
Tomoaki
T
Ikeda
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists