SynthesisHypertension (Dallas, Tex. : 1979)2022
Oral Antihypertensives for Nonsevere Pregnancy Hypertension: Systematic Review, Network Meta- and Trial Sequential Analyses.
Synthesis in Hypertension (Dallas, Tex. : 1979), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 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
31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Antihypertensive therapy for pregnancy hypertension and implications for fetal and neonatal heart rate monitoring: A systematic review of randomized trials and observational studies.Acta obstetricia et gynecologica Scandinavica · 2025Pooled it
- Blood pressure-lowering treatment for pregnant women with non-severe hypertension: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Pooled it
- A hypotensive protocol of inspiratory muscle strength training: Systematic review and meta-analysis with trial sequential analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2023Pooled it
- The impact of antihypertensive treatment of mild to moderate hypertension during pregnancy on maternal and neonatal outcomes: An updated meta-analysis of randomized controlled trials.Clinical cardiology · 2023Pooled it
- Hypertension Management in Pregnancy and Postpartum.Journal of the American Society of Nephrology : JASN · 2026Review
- Article
- Labetalol, Nifedipine, and Methyldopa for the Management of Hypertensive Disorders in Pregnancy in Iran: A Cost-Effectiveness Analysis.Health science reports · 2026Article
- A comparison of the safety of oral labetalol versus nifedipine to manage hypertension in pregnancy in Australia: a target trial emulation.EClinicalMedicine · 2026Article
- Antihypertensive drug use for hypertensive disorders of pregnancy in hospitals across nine Chinese cities: a real-world data study.BMC pregnancy and childbirth · 2026Article
- Review
- Effects of Genetically-Proxied Antihypertensive Drug Targets on Preeclampsia and Birth Weight.medRxiv : the preprint server for health sciences · 2026Article
- Safety of Antihypertensive Medication for the Management of Non-Severe Gestational Hypertension Among Pregnant Individuals in Botswana-Emulating a Series of Target Trials.Paediatric and perinatal epidemiology · 2026Article
- Does geographical location impact the efficacy of oral antihypertensive therapy in pregnancy?Journal of the Turkish German Gynecological Association · 2025Article
- Article
- Nonsevere hypertensive disorders of pregnancy and oral antihypertensive medications: an argument in favor of use.American journal of obstetrics & gynecology MFM · 2025Review
- Expectant Management of Severe Preeclampsia in Advanced Maternal Age With Multiple Risk Factors: A Case Report.Cureus · 2025Article
- Hypertensive Disorders of Pregnancy: Diagnosis, Management and Timing of Birth.Balkan medical journal · 2024Review
- Pharmacotherapeutic options for the treatment of hypertension in pregnancy.Expert opinion on pharmacotherapy · 2024Review
- Chronic Hypertension During Pregnancy: Prevalence and Treatment in the United States, 2008-2021.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Genetic Insights Into Perinatal Outcomes of Maternal Antihypertensive Therapy During Pregnancy.JAMA network open · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundWe aimed to address which antihypertensives are superior to placebo/no therapy or another antihypertensive for controlling nonsevere pregnancy hypertension and provide future sample size estimates for definitive evidence.
methodsRandomized trials of antihypertensives for nonsevere pregnancy hypertension were identified from online electronic databases, to February 28, 2021 (registration URL: https://www.crd.york.ac.uk/PROSPERO/; unique identifier: CRD42020188725). Our outcomes were severe hypertension, proteinuria/preeclampsia, fetal/newborn death, small-for-gestational age infants, preterm birth, and admission to neonatal care. A Bayesian random-effects model generated estimates of direct and indirect treatment comparisons. Trial sequential analysis informed future trials needed.
resultsOf 1246 publications identified, 72 trials were included; 61 (6923 women) were informative. All commonly prescribed antihypertensives (labetalol, other β-blockers, methyldopa, calcium channel blockers, and mixed/multi-drug therapy) versus placebo/no therapy reduced the risk of severe hypertension by 30% to 70%. Labetalol decreased proteinuria/preeclampsia (odds ratio, 0.73 [95% credible interval, 0.54-0.99]) and fetal/newborn death (odds ratio, 0.54 [0.30-0.98]) compared with placebo/no therapy, and proteinuria/preeclampsia compared with methyldopa (odds ratio, 0.66 [0.44-0.99]) and calcium channel blockers (odds ratio, 0.63 [0.41-0.96]). No other differences were identified, but credible intervals were wide. Trial sequential analysis indicated that 2500 to 10 000 women/arm (severe hypertension or safety outcomes) to >15 000/arm (fetal/newborn death) would be required to provide definitive evidence.
conclusionsIn summary, all commonly prescribed antihypertensives in pregnancy reduce the risk of severe hypertension, but labetalol may also decrease proteinuria/preeclampsia and fetal/newborn death. Evidence is lacking for many other safety outcomes. Prohibitive sample sizes are required for definitive evidence. Real-world data are needed to individualize care.
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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.