Authors: Shaba N Molvi Shahida Mir Vikram S Rana Farhat Jabeen A Rauoof Malik
Publish Date: 2012/01/15
Volume: 285, Issue: 6, Pages: 1553-1562
Abstract
A total of 150 consecutive pregnant women without proteinuria and with physicianrecorded systolic BP of 140–160 mmHg and/or diastolic BP of 90–105 mmHg on two occasions ≥6 h apart between 20 and 38 weeks of gestation were randomly allocated to receive either labetalol or methyldopa 50 patients each plus standard care treatment group or only standard care 50 patients control groupAs compared to the control group the treatment group had lower rates of severe PIH 28 vs 10 P = 0005 proteinuria 28 vs 12 P = 0016 hospitalization before term 28 vs 14 P = 0041 and delivery by cesarean section 38 vs 22 P = 0042 In a multivariable logistic regression model that adjusted for maternal age weight parity previous PIH and baseline hemoglobin resting heart rate and BP levels antihypertensive therapy was associated with a lower incidence of adverse maternal events P = 0011 Compared to the control group the treatment group had lower incidence of SGA babies 40 vs 23 P = 0033 preterm birth 36 vs 14 P = 0002 and admission to neonatal unit 30 vs 15 P = 0036 After adjustment for maternal age weight baseline hemoglobin resting heart rate BP level parity and previous history of PIH fetal death preterm delivery or SGA baby antihypertensive therapy was associated with a lower incidence of adverse perinatal events P = 0016 Maternal and perinatal mortality rates were not significantly different between treatment and control groups In conclusion pharmacological treatment of mild to moderate PIH is associated with lower rate of some maternal and fetalneonatal nonfatal adverse events compared to no routine use of antihypertensive therapyWe thank two anonymous reviewers for helpful comments and Arvind Kavishwar MSc BioStatistician Regional Medical Research Centre for Tribals Indian Council of Medical Research RMRCT Complex Garha Jabalpur 482003 MP India for help in statistical analyses
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