Evidence map›Paper›PMID 40772922›Full record

ArticleJACC. Advances2025

Comparative Effectiveness and Safety of Labetalol Versus Nifedipine for Treatment of Chronic Hypertension During Pregnancy.

Stephanie A Leonard, Sara Siadat, Krista F Huybrechts, Elliott K Main, Mark A Hlatky, Sonia Hernández-Díaz, Brian T Bateman

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PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Hypertension Management in Pregnancy and Postpartum.Journal of the American Society of Nephrology : JASN · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stephanie A LeonardDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA. Electronic address: stephanie.leonard@stanford.edu.
Sara SiadatDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Krista F HuybrechtsDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Elliott K MainDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA.
Mark A HlatkyDepartment of Health Policy, Stanford University School of Medicine, Stanford, California, USA; Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Sonia Hernández-DíazDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Brian T BatemanDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
Optimizing treatment of chronic hypertension in pregnancy using a national distributed data networkK01HL171699 · NHLBI · STANFORD UNIVERSITY · PI Stephanie A. Leonard · 2024 to 2026
$514k
NCATS NIH HHS UL1 TR003142NHLBI NIH HHS K01 HL171699
6 · The paper itself

Abstract

backgroundClinical guidelines recommend treatment of chronic hypertension during pregnancy, with either labetalol or nifedipine as the first-line medication.

objectivesThis study aimed to compare the effectiveness and safety of labetalol and nifedipine for the treatment of chronic hypertension during pregnancy.

methodsWe used a target trial emulation approach to compare new users of labetalol with new users of nifedipine. We analyzed data from the U.S. Merative™ MarketScan® Commercial Database of insurance claims (2007-2022) for pregnant individuals with chronic hypertension and their infants. The effectiveness outcome was a composite of severe preeclampsia/eclampsia, medically indicated preterm birth, placental abruption, or stillbirth. The safety outcome was an infant born small for gestational age. We estimated risk ratios (RRs) and risk differences (RDs) with 95% CIs, adjusting for confounding with stabilized inverse probability of treatment weights.

resultsWe studied 6,724 pregnant individuals with chronic hypertension who initiated either labetalol (n = 5,504, 82%) or nifedipine (n = 1,220, 18%) in pregnancy. The effectiveness outcome occurred in 42% in the labetalol group and 44% in the nifedipine group, with an adjusted RR of 1.03 (95% CI: 0.96-1.11) and an adjusted RD of 1.35 per 100 births (95% CI: -1.76 to 4.45). The safety outcome of small for gestational age occurred in 13% in the labetalol group and 12% in the nifedipine group, with an adjusted RR of 0.98 (95% CI: 0.82-1.16) and an adjusted RD of -0.26 per 100 births (95% CI: -2.33 to 1.81).

conclusionsThis study suggests that labetalol and nifedipine have similar effectiveness and safety in treating chronic hypertension during pregnancy.

Indexed as

antihypertensive agentshypertensionlabetalolnifedipinepreeclampsiapregnancy

Identifiers

PMID40772922
PMCPMC12539438

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Registered trials

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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.