American Journal of Obstetrics & Gynecology
Volume 201, Issue 2 , Pages 180.e1-180.e8 , August 2009

Discontinuation of antihypertensive drug use during the first trimester of pregnancy and the risk of preeclampsia and eclampsia among women with chronic hypertension

Presented at the 48th Annual Meeting of the Teratology Society, Monterey, CA, June 28-July 2, 2008.

  • Hamid Reza Nakhai-Pour, MD, PhD

      Affiliations

    • Faculty of Pharmacy, University of Montreal, Montreal, Québec, Canada
    • Research Center, CHU Ste-Justine, Montreal, Québec, Canada
    • Ministry of Health and Medical Education, Tehran, Iran
    • ,
  • Evelyne Rey, MD, MSc

      Affiliations

    • Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
    • Research Center, CHU Ste-Justine, Montreal, Québec, Canada
    • ,
  • Anick Bérard, PhD

      Affiliations

    • Faculty of Pharmacy, University of Montreal, Montreal, Québec, Canada
    • Research Center, CHU Ste-Justine, Montreal, Québec, Canada
    • Corresponding Author InformationReprints: Anick Bérard, PhD, Sainte-Justine Hospital Research Center, 3175, chemin de la Côte-Ste-Catherine, Montreal (Québec) H3T 1C5 Canada

Received 2 September 2008 ,Revised 12 February 2009 ,Accepted 14 May 2009.

References 

  1. Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183:1–22
  2. Sibai B. Chronic hypertension in pregnancy. Obstet Gynecol. 2002;100:369–377
  3. Gilbert W, Young A, Danielsen B. Pregnancy outcomes in women with chronic hypertension: a population-based study. J Reprod Med. 2007;52:1046–1051
  4. Sibai BM, Lindheimer M, Hauth J, et al. Risk factors for preeclampsia, abruptio placentae, and adverse neonatal outcomes among women with chronic hypertension. N Engl J Med. 1998;339:667–671
  5. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PFA. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066–1074
  6. Canada H. Special report on maternal mortality and severe morbidity in Canada enhanced surveillance: the path to prevention. Ottawa, Canada: Minister of Public Works and Government Services; 2004;
  7. Krzesinski J. Hypertension at pregnancy. Rev Med Liege. 1999;54:415–423
  8. Magee LA, Ornstein MP, von Dadelszen P. Fortnightly review: management of hypertension in pregnancy. BMJ. 1999;318:1332–1336
  9. Abalos E, Duley L, Steyn D, Henderson-Smart D. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2007;24:CD002252
  10. World Health Organization. International classification of diseases. Geneva, Switzerland: WHO; 1997;
  11. Régie de l'assurance maladie du Québec. Statistiques annuelles. Government of Québec, Canada: RAMQ; 1997;
  12. Ramos E, St-Andre M, Rey E, Oraichi D, Bérard A. Duration of antidepressant use during pregnancy and risk of major congenital malformations. Br J Psychiatry. 2008;192:344–350
  13. Ofori B, Rey E, Bérard A. Risk of congenital anomalies in pregnant users of statin drugs. Br J Clin Pharmacol. 2007;64:496–509
  14. Blais L, Beauchesne MF, Rey E, Malo JL, Forget A. Use of inhaled corticosteroids during the first trimester of pregnancy and the risk of congenital malformations among women with asthma. Thorax. 2007;62:320–328
  15. Bérard A, Ramos E, Rey E, Blais L, St-Andre M, Oraichi D. First trimester exposure to paroxetine and risk of cardiac malformations in infants: the importance of dosage. Birth Defects Res B Dev Reprod Toxicol. 2007;80:18–27
  16. Ramos E, Oraichi D, Rey E, Blais L, Bérard A. Prevalence and predictors of antidepressant use in a cohort of pregnant women. BJOG. 2007;114:1055–1064
  17. Ofori B, Oraichi D, Blais L, Rey E, Bérard A. Risk of congenital anomalies in pregnant users of non-steroidal anti-inflammatory drugs: a nested case-control study. Birth Defects Res B Dev Reprod Toxicol. 2006;77:268–279
  18. Tamblyn R, Lavoie G, Petrella L, Monette J. The use of prescription claims databases in pharmacoepidemiological research: the accuracy and comprehensiveness of the prescription claims database in Québec. J Clin Epidemiol. 1995;48:999–1009
  19. Levy AR, Mayo NE, Grimard G. Rates of transcervical and pertrochanteric hip fractures in the Province of Québec, Canada, 1981-1992. Am J Epidemiol. 1995;142:428–436
  20. Vilain A, Otis S, Forget A, Blais L. Agreement between administrative databases and medical charts for pregnancy-related variables among asthmatic women. Pharmacoepidemiol Drug Saf. 2008;17:345–353
  21. Essebag V, Genest J, Suissa S, Pilote L. The nested case-control study in cardiology. Am Heart J. 2003;146:581–590
  22. Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350:672–683
  23. Khong T, de Wolf F, Robertson W, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational-age infants. Br J Obstet Gynaecol. 1986;93:1049–1059
  24. Zuspan F, O'Shaughnessy R. Maternal physiology and diseases: chronic hypertension in pregnancy. In:  Pitkin RM,  Zlatnik FJ editor. Yearbook of obstetrics and gynecology. Chicago: Yearbook Medical Publishers; 1979;
  25. von Dadelszen P, Magee L. Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: an updated meta-regression analysis. J Obstet Gynaecol Can. 2002;24:941–945
  26. von Dadelszen P, Ornstein MP, Bull SB, Logan AG, Koren G, Magee LA. Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: a meta-analysis. Lancet. 2000;355:87–92
  27. Leather HM, Humphreys DM, Baker PB, Chadd MA. A controlled trial of hypotensive agents in hypertension in pregnancy. Lancet. 1968;2:488–490
  28. Redman CWG. Fetal outcome in trial of antihypertensive treatment in pregnancy. Lancet. 1976;2:753–756
  29. Arias F, Zamora J. Antihypertensive treatment and pregnancy outcome in patients with mild chronic hypertension. Obstet Gynecol. 1979;53:489–494
  30. Sibai BM, Grossman RA, Grossman HG. Effects of diuretics on plasma volume in pregnancies with long-term hypertension. Am J Obstet Gynecol. 1984;150:831–835
  31. Weitz C, Khouzami V, Maxwell K, Johnson JWC. Treatment of hypertension in pregnancy with methyldopa: a randomized double blind study. Int J Gynaecol Obstet. 1987;25:35–40
  32. Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy. BMJ. 1990;301:587–589
  33. Sibai BM, Mabie WC, Shamsa F, Villar MA, Anderson GD. A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol. 1990;162:960–967
  34. Collins R, Yusuf S, Peto R. Overview of randomized trials of diuretics in pregnancy. BMJ. 1985;29:17–23
  35. Glover DD, Amonkar M, Rybeck BF, Tracy TS. Prescription, over-the-counter, and herbal medicine use in a rural, obstetric population. Am J Obstet Gynecol. 2003;188:1039–1045

 Cite this article as: Nakhai-Pour HR, Rey E, Bérard A. Discontinuation of antihypertensive drug use during the first trimester of pregnancy and the risk of preeclampsia and eclampsia among women with chronic hypertension. Am J Obstet Gynecol 2009;201:180.e1-8.

 The study was supported by the Fonds de la Recherche en Santé du Québec (FRSQ), Réseau québécois de recherche sur l'usage des médicaments (RQRUM), and the National Cancer Institute of Canada (NCIC).

PII: S0002-9378(09)00527-4

doi: 10.1016/j.ajog.2009.05.019

American Journal of Obstetrics & Gynecology
Volume 201, Issue 2 , Pages 180.e1-180.e8 , August 2009

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