Cochrane · systematic review · CD002252
Antihypertensive drug therapy for mild to moderate hypertension during pregnancy
Abalos, E, Duley, L, Steyn, DW, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
11
No studies
4
Included studies
NR
No studies 4 · 26.7%Ungraded 0 · 0%Very low 3 · 20%Low 3 · 20%Moderate 5 · 33.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Any antihypertensive drug compared to no antihypertensive drugs/placebo for mild to moderate hypertension during pregnancy (primary outcomes)
Population: women with mild to moderate hypertension during pregnancy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal Any antihypertensive drug vs no antihypertensive drugs/placebo | no estimate extracted | NR | No studies |
Severe hypertension Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.49 [0.4, 0.6] | 20 studies · 2558 participants | Moderate |
Proteinuria/pre‐eclampsia Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.92 [0.75, 1.14] | 23 studies · 2851 participants | Low |
Fetal/neonatal/infant Any antihypertensive drug vs no antihypertensive drugs/placebo | no estimate extracted | NR | No studies |
Total reported fetal or neonatal deaths (including miscarriage) Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.72 [0.5, 1.04] | 29 studies · 3365 participants | Moderate |
Small‐for‐gestational age Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.96 [0.78, 1.18] | 21 studies · 2686 participants | Moderate |
Preterm birth (< 37 weeks) Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.96 [0.83, 1.12] | 15 studies · 2141 participants | Moderate |
Any antihypertensive drug compared to no antihypertensive drugs/placebo for mild to moderate hypertension during pregnancy (secondary maternal and fetal/neonatal/infant outcomes)
Population: women with mild to moderate hypertension during pregnancy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal Any antihypertensive drug vs no antihypertensive drugs/placebo | no estimate extracted | NR | No studies |
Maternal death Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 1.11 [0.18, 7.02] | 5 studies · 525 participants | Very low |
Severe pre‐eclampsia Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.56 [0.15, 2.02] | 3 studies · 416 participants | Very low |
Eclampsia Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.52 [0.13, 2.06] | 7 studies · 713 participants | Very low |
Changed/stopped drugs due to maternal side‐effects Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 1.93 [0.92, 4.06] | 16 studies · 1503 participants | Low |
Elective delivery (induction of labour + elective caesarean section) Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 0.93 [0.84, 1.04] | 4 studies · 710 participants | Moderate |
Fetal/neonatal/infant Any antihypertensive drug vs no antihypertensive drugs/placebo | no estimate extracted | NR | No studies |
Admission to neonatal or intensive care nursery Any antihypertensive drug vs no antihypertensive drugs/placebo | RR 1.01 [0.83, 1.22] | 10 studies · 1570 participants | Low |