Why the study?
Beta-blockers are often used during pregnancy to treat cardiovascular diseases, but the evidence base for described neonatal hypoglycemia and bradycardia side effects had yet to be evaluated comprehensively.
Does maternal beta-blocker use during pregnancy or lactation increase the risk of hypoglycemia and bradycardia in neonates?
Does maternal beta-blocker use during pregnancy or lactation increase the risk of hypoglycemia and bradycardia in neonates?
Maternal beta-blocker use during pregnancy is associated with a probable risk of neonatal hypoglycemia and a possible risk of bradycardia, warranting glucose and heart rate monitoring for 24 hours post-birth.
Supports glucose monitoring for 24 h in exposed neonates; reinforces moderate-certainty hypoglycemia risk while leaving bradycardia evidence open.
Beta-blockers are often used during pregnancy to treat cardiovascular diseases. The described neonatal side effects of maternal beta-blocker use are hypoglycemia and bradycardia, but the evidence base for these is yet to be evaluated comprehensively. Hence, this systematic review and meta-analysis was performed to evaluate the potential increased risk for hypoglycemia and bradycardia in neonates exposed to beta-blockers in utero or during lactation. A systematic search of English-language human studies was conducted until 21 April 2021. Both observational studies and randomized controlled trials investigating hypoglycemia and/or bradycardia in neonates following beta-blocker exposure during pregnancy and lactation were included. All articles were screened by two authors independently and eligible studies were included. Pair-wise and proportion-based meta-analysis was conducted and the certainty of evidence (CoE) was performed by standard methodologies. Of the 1.043 screened articles, 55 were included in this systematic review. Our meta-analysis showed a probable risk of hypoglycemia (CoE-Moderate) and possible risk of bradycardia (CoE-Low) in neonates upon fetal beta-blocker exposure. Therefore, we suggest the monitoring of glucose levels in exposed neonates until 24 h after birth. Due to the limited clinical implication, monitoring of the heart rate could be considered for 24 h. We call for future studies to substantiate our findings.
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Bruin et al. (2022) studied this question.
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