Antihypertensive treatment for mild pregnancy hypertension significantly reduced the risk of preeclampsia (OR 0.55; 95% CI 0.39-0.78) compared to placebo or no therapy.
Meta-Analysis (n=4,211)
Does antihypertensive treatment prevent preeclampsia and other adverse outcomes in pregnant women with mild hypertension?
Antihypertensive treatment for mild hypertension in pregnancy significantly improves maternal and pregnancy outcomes without increasing fetal risks.
Odds Ratio: 0.55 (95% CI 0.39–0.78)
OBJECTIVES: To synthesize the evidence from randomized controlled trials (RCTs) of antihypertensive treatment for mild pregnancy hypertension. METHODS: We searched various databases from inception to June 2022, using keywords including hypertension; pregnancy; therapy; treatment; pregnancy outcomes; maternal outcomes; and perinatal outcomes. Only RCTs of antihypertensive treatment for mild hypertension in pregnancy comparing placebo/no therapy were included. We used Review Manager version 5.3 for statistical analyses. RESULTS: In all, eight studies were eligible, with a total of 4211 participants. Compared with control, the active treatment significantly prevented preeclampsia (OR 0.55; 95%CI, 0.39-0.78), placental abruption (OR 0.39; 95%CI, 0.17-0.91), severe hypertension (OR 0.35; 95%CI, 0.17-0.71), end-organ dysfunction (OR 0.34; 95%CI, 0.19-0.62) and preterm birth (OR 0.69; 95%CI, 0.59-0.82), with no increased risk of small for gestational age (SGA) (OR 1.25; 95%CI, 0.78-2.00), or admission to the NICU (OR 0.83; 95%CI, 0.54-1.28). Subgroup analyses demonstrated that the tight control group did not show an advantage over the less-tight control group in improving pregnancy outcomes. CONCLUSION: In pregnant women with mild pregnancy-induced hypertension or chronic hypertension, antihypertensive treatment still provided precise benefits of improving pregnancy outcomes without increased risk in fetal outcomes.
Chen et al. (2022) conducted a meta-analysis in mild pregnancy hypertension (n=4,211). antihypertensive treatment vs. placebo/no therapy was evaluated on preeclampsia (OR 0.55, 95% CI 0.39-0.78). Antihypertensive treatment for mild pregnancy hypertension significantly reduced the risk of preeclampsia (OR 0.55; 95% CI 0.39-0.78) compared to placebo or no therapy.