Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Aug 8;52(8):858-862.
doi: 10.1515/jpm-2024-0114. Print 2024 Oct 28.

Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis

Shauna Bratton  1 , Megan K Taylor  1 , Priscilla Cortez  1 , Antonio Schiattarella  2 , Cecilia Fochesato  3 , Giovanni Sisti  4
Affiliations
Free article
Meta-Analysis

Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis

Shauna Bratton et al. J Perinat Med. .
Free article

Abstract

Objectives: Atenolol is a commonly used beta bloscker in non-pregnant women. Many providers are hesitant in prescribing atenolol in pregnancy because of a possible association with poor fetal growth. We aimed to assess the association between atenolol and the occurrence of small for gestational age neonates compared to other beta blockers, as described in the existing literature.

Methods: We used the meta-analytic method to generate a forest plot for risk ratios (RR) of small for gestational age in patients who used atenolol vs. other beta blockers. Statistical heterogeneity was assessed with the I2 statistic.

Results: Two studies were included, with a resultant RR of 1.94 [95 % confidence interval (CI) 1.60; 2.35]. A study by Duan et al. in 2018 noted the following rate of small for gestational age for each beta blocker use: 112/638 atenolol, 590/3,357 labetalol, 35/324 metoprolol, and 50/489 propranolol. A study by Tanaka et al. in 2016 noted the following rate of small for gestational age: 8/22 for propranolol, 2/12 for metoprolol, 2/6 for atenolol, 0/5 for bisoprolol. Heterogeneity (I2) was 0 %.

Conclusions: Our results suggested an elevated risk of small for gestational age associated with atenolol use in comparison to other beta blockers, specifically labetalol, propranolol, bisoprolol, and metoprolol.

Keywords: atenolol; atenolol in pregnancy; beta blocker in pregnancy; fetal growth restriction; intrauterine growth restriction; small for gestational age.

PubMed Disclaimer

References

    1. Beta-blockers – one size blocks them all? Updates in pharmacogenetic education. Arlington, VA: American Association of Colleges of Pharmacy (AACP); 2023.
    1. Farzam, K, Jan, A. Beta blockers. StatPearls . Treasure Island (FL): National Library of Medicine. StatPearls Publishing; 2023.
    1. Lydakis, C, Lip, GY, Beevers, M, Beevers, DG. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens 1999;12:541–7. https://doi.org/10.1016/s0895-7061(99)00031-x . - DOI
    1. Gelson, E, Curry, R, Gatzoulis, MA, Swan, L, Lupton, M, Steer, P, et al.. Effect of maternal heart disease on fetal growth. Obstet Gynecol 2011;117:886–91. https://doi.org/10.1097/AOG.0b013e31820cab69 . - DOI
    1. Bristow, MR. Pathophysiologic and pharmacologic rationales for clinical management of chronic heart failure with beta‐blocking agents. Am J Cardiol 1993;71:12C–22C. https://doi.org/10.1016/0002-9149(93)90082-n . - DOI

Publication types

MeSH terms

Substances

LinkOut - more resources