Comparative efficacy and safety of antihypertensive agents in
preeclampsia and gestational hypertension uncontrolled and their
long-term effects on offspring
Abstract
Background: Hypertensive disorder of pregnancy (HDP), a common obstetric
complication that seriously threatens maternal and infant health. The
current clinical treatment drugs include methyldopa, calcium channel
blockers, etc. In order to provide evidence-based medicine for the
treatment and medication of gestational hypertension, this study
compared the efficacy and safety of different drugs in the treatment of
gestational hypertension through network meta-analysis. Methods: Search
and select relevant articles in the published and unpublished available
data from Controlled Trials, PsycINFO, CINAHL,, etc. To assess the
efficacy and safety of HDP treatment, 4 primary outcomes [SBP, DBP,
perinatal fetal deaths, and NICU cases] and 9 secondary outcomes were
selected. Results: 50 articles with 8212 participants were included. Low
molecular weight heparin (LMH), Labetalol + LMH and Labetalol +
Methyldopa can reduce DBP, and Ambrisentan + Methyldopa can prevent the
occurrence of severe hypertension. Methyldopa and Atenolol were
associated with lower rates of preterm birth, and Nifedipine, Methyldopa
as well as Labetalol reduced the incidence of placental abruption.
Ambrisentan + Nifedipine, Methyldopa, Labetalol + Nimodipine, Labetalol
+ LMH, Labetalol and LMH significantly reduced the incidence of
postpartum complications. Magnesium sulfate (SM) and SM+ LMH can prolong
the mean gestational age, LMH and Kethyldopa can reduce perinatal fetal
death. Conclusions: LMH, labetalol, Methyldopa, labetalol in combination
with LMH, and labetalol in combination with Methyldopa have better
efficacy and safety.