[Maternal effects and perinatal safety of labetalol in the treatment of hypertension in pregnancy. Comparison with methyldopa in a randomized cooperative trial]

Abstract

Labetalol was compared with methyldopa in a randomised trial involving 176 pregnant women with mild to moderate hypertension. Effective blood pressure control (diastolic pressure below 86 mmHg) was obtained in a similar proportion of mothers given labetalol or methyldopa, but the addition of a complementary treatment to achieve control was less frequently needed in the labetalol than in the methyldopa group (12/91 vs 22/85 p less than 0.05). Side effects were mild and resulted in discontinuation of the randomised treatment in 1 mother given labetalol. Pregnancy was terminated by intrauterine death in 4 mothers given methyldopa, and one neonate born to a patient allocated to labetalol died at day 1. The average birthweight and the proportion of premature delivery or of small for gestational age newborns were similar in both treatment groups. Heart rate, blood pressure, respiratory rate and blood glucose did not differ between infants born to the mothers of the labetalol and the methyldopa groups, irrespective of gestational age at birth or birthweight. Blood pressure control is more frequently achieved in hypertensive pregnancies with labetalol than with methyldopa as a first line treatment. Labetalol is safe to the fetus and newborn and might offer a better prevention of intrauterine death than methyldopa.