Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Internal Medicine, Evangelismos General Hospital, Athens, Greece.
Curr Hypertens Rep. 2023 Feb;25(2):13-24. doi: 10.1007/s11906-023-01234-8. Epub 2023 Feb 3.
The aim of this review was to determine the anticipated benefits and adverse effects of beta-blockers in pregnant women with hypertension. The other issue was to assess the possible adverse effects of beta-blockers for their babies and provide current consensus recommendations for appropriate selection and individualized antihypertensive treatment with beta-blockers in pregnancy-associated hypertension.
Hypertensive disorders of pregnancy are a major cause of maternal and fetal morbidity, with consequences later in life. Certain beta-blockers are useful for ameliorating hypertension in pregnancy and may have a protective role in endothelial dysfunction. However, some aspects of beta-blocker use in pregnancy are contentious among providers. Evidence on their safety, although well documented, is variable, and recent research reveals areas of controversy. Besides intrauterine growth restriction, other neonatal and obstetric complications remain a concern and should be explored thoroughly. Attention is necessary when treating pregnancy-associated hypertensive disorders with beta-blockers. Specific beta-blockers are considered safe in pregnancy, although the associated effects in the fetus are not clearly known and evidence is lacking for many safety outcomes, other than intrauterine growth restriction. Nevertheless, beta-blockers with specific indications in pregnancy under individualized selection and monitoring may confer substantial improvements in pregnant women with hypertension.
本综述旨在确定β受体阻滞剂在高血压孕妇中的预期益处和不良反应。另一个问题是评估β受体阻滞剂对其婴儿的可能不良反应，并为与妊娠相关的高血压中β受体阻滞剂的适当选择和个体化降压治疗提供当前的共识建议。
妊娠高血压疾病是孕产妇和胎儿发病率的主要原因，对以后的生活有影响。某些β受体阻滞剂可有效改善妊娠高血压，并且可能在血管内皮功能障碍中具有保护作用。然而，在妊娠中使用β受体阻滞剂的某些方面在提供者中存在争议。尽管有关其安全性的证据记录良好，但证据是可变的，最近的研究揭示了存在争议的领域。除了宫内生长受限，其他新生儿和产科并发症仍然令人担忧，应进行彻底探讨。在使用β受体阻滞剂治疗与妊娠相关的高血压疾病时需要注意。特定的β受体阻滞剂在妊娠中被认为是安全的，尽管在胎儿中相关的影响尚不清楚，并且除了宫内生长受限之外，许多安全性结果的证据也缺乏。然而，在个体化选择和监测下，具有特定妊娠适应证的β受体阻滞剂可能会为患有高血压的孕妇带来实质性的改善。
