Is the Use of Beta-blockers in Pregnancy Related to Fetal Cardiac Anomalies?
BACKGROUND AND PURPOSE:
Beta-blockers are widely used for treating cardiac conditions in pregnancy, but safety data is limited
Duan et. al. (JAMA Internal Medicine, 2017) examined the risk of fetal congenital cardiac anomalies related to the use of beta-blockers in pregnancy
Retrospective population-based cohort study of pregnant women exposed to beta-blockers
Singleton pregnancies between 2003-2014
Primary outcome was fetal cardiac anomalies
Multivariable logistic regression models were used to address other possible contributing factors
Out of 379,238 pregnancies, 4847 (1.3%) were exposed to beta-blockers and of those 2628 (0.7%) were exposed in the first trimester
Most common beta-blockers were
labetalol (n = 3357)
atenolol (n = 638)
propranolol (n = 489)
metoprolol (n = 324)
Any association between beta-blockers and fetal cardiac anomalies was no longer apparent after adjusting for maternal age, maternal BMI, and maternal comorbidities
Any previous studies that demonstrated a relationship between beta-blockers and fetal cardiac anomalies may have been due to confounding
The authors conclude that while their study does not definitively rule out an association between beta-blockers and fetal cardiac anomalies, it should reassure patients and providers who do require these medications during pregnancy
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
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