Beta-blockers, particularly labetalol, are the mainstay treatment for maternal hypertension, but their use is associated with potential fetal and neonatal risks such as growth restriction and hypoglycemia.
This narrative review highlights labetalol as the preferred beta-blocker for hypertension in pregnancy and emphasizes the need for further pharmacokinetic and safety studies for beta-blocker use in maternal, neonatal, and pediatric populations.
Beta-blockers are a class of medications that act on beta-adrenergic receptors and are categorized as cardio-selective and non-selective. They are principally used to treat cardiovascular conditions such as hypertension and arrhythmias. Beta-blockers have also been used to treat non-cardiogenic indications in non-pregnant individuals and the pediatric population. In pregnancy, labetalol is the mainstay treatment for hypertension and other cardiovascular indications. However, contraindications to certain sub-types of beta-blockers include bradycardia, heart failure, obstructive lung diseases, and hemodynamic instability. There is conflicting evidence of the adverse effects on fetal and neonatal health due to a scarce safety and efficacy profile, and further studies are necessary to understand the pharmacokinetics of the different classes of beta-blockers in pregnancy and fetal health. Understanding the hemodynamic changes during the stages of pregnancy is important to target a more beneficial therapy for both mother and fetus as well as better neonatal outcomes. Beta-blocker use in the pediatric population is less documented in studies but does have the potential to treat various cardiogenic and non-cardiogenic conditions. Future comprehensive studies would further benefit the direction of beta-blocker treatment during pregnancy in neonates and pediatrics.
Martinez et al. (Thu,) conducted a review in Hypertension and cardiovascular disease in pregnancy. Beta-blockers was evaluated. Beta-blockers, particularly labetalol, are the mainstay treatment for maternal hypertension, but their use is associated with potential fetal and neonatal risks such as growth restriction and hypoglycemia.