Postpartum hypertension is a frequent cause of maternal morbidity and mortality. The objective of this study was to compare the effectiveness and safety of pharmacological agents for management of postpartum hypertension. We searched the MEDLINE and Embase through July 2025. The studies which were randomized controlled trials enrolling women with postpartum hypertension. Eligible trials compared active agents or placebo/usual care and reported blood pressure outcomes. Primary outcomes were time to achieve blood pressure control (hours) and proportion of women achieving blood pressure control within seven days postpartum. Bayesian random-effects network meta-analysis was performed with Metainsight. Thirteen randomized controlled trials were identified. For time to blood pressure control , amlodipine and nifedipine ranked highest. Compared with labetalol, amlodipine reduced time to control blood pressure by 5.85 h and nifedipine by 5.11 h. Rankings indicated Calcium Channel Blockers were most effective for rapid control, followed by labetalol. For the proportion achieving control within seven days , labetalol ranked highest, with a probability near 100%. Compared with labetalol, risk ratios for blood pressure control were 1.01 for nifedipine, 1.03 for hydralazine, and 1.31 for hydrochlorothiazide–lisinopril. SUCRA values ranked labetalol highest, followed by nifedipine, hydralazine, and hydrochlorothiazide–lisinopril. Calcium channel blockers appear most effective for rapid reduction of blood pressure after childbirth, while labetalol is most reliable for sustained control within the first postpartum week. These findings provide a comparative framework for treatment selection and emphasize the need for larger, rigorously designed postpartum hypertension trials. PROSPERO Registration Number: CRD420251104693 .
Singh et al. (Mon,) studied this question.