Observational studyAnnals of internal medicine2018
β-Blocker Use in Pregnancy and the Risk for Congenital Malformations: An International Cohort Study.
Observational study in Annals of internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Risk for Neonatal Hypoglycemia and Bradycardia after Beta-Blocker Use during Pregnancy or Lactation: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Oral Antihypertensives for Nonsevere Pregnancy Hypertension: Systematic Review, Network Meta- and Trial Sequential Analyses.Hypertension (Dallas, Tex. : 1979) · 2022Pooled it
- Beta-Blockers for the Treatment of Arrhythmias: Which Drug for Which Arrhythmia? A State-of-the-Art Narrative Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Review
- Safety and Effectiveness of Pain Medications for Migraine Management During Pregnancy and Lactation.Paediatric drugs · 2026Review
- Review
- The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Cumulative evidence for the association between maternal hypertension and cleft lip and palate in offspring: a systematic review and meta-analysis.Frontiers in oral health · 2026Review
- Current Understanding on Hypertensive Disorders in Pregnancy.International journal of general medicine · 2026Review
- Practical compendium of antiarrhythmic drugs: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Evaluating the agreement between sensitivity and primary analyses in observational studies using routinely collected healthcare data: a meta-epidemiology study.BMC medicine · 2025Article
- The impact of maternal systemic diseases on the occurrence of cleft lip and palate in newborns: a narrative review.Frontiers in public health · 2025Review
- Review
- Effectiveness and safety of intravenous labetalol in severe pre-eclampsia and eclampsia at a teaching institution in Chhattisgarh.Journal of family medicine and primary care · 2024Article
- Development and evaluation of an algorithm to link mothers and infants in two US commercial healthcare claims databases for pharmacoepidemiology research.BMC medical research methodology · 2023Article
- Mobile Cardiac Telemetry Use to Predict Adverse Pregnancy Outcomes in Patients With Congenital Heart Disease.JACC. Advances · 2023Article
- Beta-Blockers and Their Current Role in Maternal and Neonatal Health: A Narrative Review of the Literature.Cureus · 2023Review
- Association of In Utero Antipsychotic Medication Exposure With Risk of Congenital Malformations in Nordic Countries and the US.JAMA psychiatry · 2023Article
- 2023 National Heart Center/Saudi Heart Association Focused Update of the 2019 Saudi Heart Association Guidelines for the Management of Heart Failure.Journal of the Saudi Heart Association · 2023Article
- Metoprolol Inhibits Developmental Brain Sterol Biosynthesis in Mice.Biomolecules · 2022Article
- Article
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Authors and funding
15 authors.
Funding
Abstract
Background: β-Blockers are a class of antihypertensive medications that are commonly used in pregnancy. Objective: To estimate the risks for major congenital malformations associated with first-trimester exposure to β-blockers. Design: Cohort study. Setting: Health registries in the 5 Nordic countries and the U.S. Medicaid database. Patients: Pregnant women with a diagnosis of hypertension and their offspring. Measurements: First-trimester exposure to β-blockers was assessed. Outcomes were any major congenital malformation, cardiac malformations, cleft lip or palate, and central nervous system (CNS) malformations. Propensity score stratification was used to control for potential confounders. Results: Of 3577 women with hypertensive pregnancies in the Nordic cohort and 14 900 in the U.S. cohort, 682 (19.1%) and 1668 (11.2%), respectively, were exposed to β-blockers in the first trimester. The pooled adjusted relative risk (RR) and risk difference per 1000 persons exposed (RD1000) associated with β-blockers were 1.07 (95% CI, 0.89 to 1.30) and 3.0 (CI, -6.6 to 12.6), respectively, for any major malformation; 1.12 (CI, 0.83 to 1.51) and 2.1 (CI, -4.3 to 8.4) for any cardiac malformation; and 1.97 (CI, 0.74 to 5.25) and 1.0 (CI, -0.9 to 3.0) for cleft lip or palate. For CNS malformations, the adjusted RR was 1.37 (CI, 0.58 to 3.25) and the RD1000 was 1.0 (CI, -2.0 to 4.0) (based on U.S. cohort data only). Limitation: Analysis was restricted to live births, exposure was based on dispensed medication, and cleft lip or palate and CNS malformations had few outcomes. Conclusion: The results suggest that maternal use of β-blockers in the first trimester is not associated with a large increase in the risk for overall malformations or cardiac malformations, independent of measured confounders. Primary Funding Source: The Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Söderström König Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.