Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease

Kayo Tanaka, Hiroaki Tanaka, Chizuko Kamiya, Shinji Katsuragi, Masami Sawada, Mitsuhiro Tsuritani, Masashi Yoshida, Naoko Iwanaga, Jun Yoshimatsu, Tomoaki Ikeda

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

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). Methods and 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.

Original languageEnglish
Pages (from-to)2221-2226
Number of pages6
JournalCirculation Journal
Volume80
Issue number10
DOIs
Publication statusPublished - 2016
Externally publishedYes

Fingerprint

Adrenergic Antagonists
Fetal Development
Pregnant Women
Cardiovascular Diseases
Mothers
Control Groups
Incidence
Bisoprolol
Pregnancy
Metoprolol
Atenolol
Propranolol
Fetus

Keywords

  • Beta-adrenergic blocker
  • Cardiovascular disease
  • Fetal growth restriction
  • Pregnancy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Tanaka, K., Tanaka, H., Kamiya, C., Katsuragi, S., Sawada, M., Tsuritani, M., ... Ikeda, T. (2016). Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. Circulation Journal, 80(10), 2221-2226. https://doi.org/10.1253/circj.CJ-15-0617

Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. / Tanaka, Kayo; Tanaka, Hiroaki; Kamiya, Chizuko; Katsuragi, Shinji; Sawada, Masami; Tsuritani, Mitsuhiro; Yoshida, Masashi; Iwanaga, Naoko; Yoshimatsu, Jun; Ikeda, Tomoaki.

In: Circulation Journal, Vol. 80, No. 10, 2016, p. 2221-2226.

Research output: Contribution to journalArticle

Tanaka, K, Tanaka, H, Kamiya, C, Katsuragi, S, Sawada, M, Tsuritani, M, Yoshida, M, Iwanaga, N, Yoshimatsu, J & Ikeda, T 2016, 'Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease', Circulation Journal, vol. 80, no. 10, pp. 2221-2226. https://doi.org/10.1253/circj.CJ-15-0617
Tanaka K, Tanaka H, Kamiya C, Katsuragi S, Sawada M, Tsuritani M et al. Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. Circulation Journal. 2016;80(10):2221-2226. https://doi.org/10.1253/circj.CJ-15-0617
Tanaka, Kayo ; Tanaka, Hiroaki ; Kamiya, Chizuko ; Katsuragi, Shinji ; Sawada, Masami ; Tsuritani, Mitsuhiro ; Yoshida, Masashi ; Iwanaga, Naoko ; Yoshimatsu, Jun ; Ikeda, Tomoaki. / Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. In: Circulation Journal. 2016 ; Vol. 80, No. 10. pp. 2221-2226.
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abstract = "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). Methods and 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.",
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AU - Sawada, Masami

AU - Tsuritani, Mitsuhiro

AU - Yoshida, Masashi

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AU - Yoshimatsu, Jun

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N2 - 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). Methods and 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.

AB - 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). Methods and 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.

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