College of Medicine, University of Arizona, Tucson, AZ, USA.
Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy.
J Perinat Med. 2024 Aug 8;52(8):858-862. doi: 10.1515/jpm-2024-0114. Print 2024 Oct 28.
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.
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 I statistic.
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 (I) was 0 %.
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.
阿替洛尔是一种常用于非妊娠女性的β受体阻滞剂。由于其可能与胎儿生长不良有关，许多医生在怀孕期间都不愿开阿替洛尔。我们旨在评估阿替洛尔与其他β受体阻滞剂相比，与胎儿生长受限的发生之间的关系，正如现有文献中所描述的那样。
我们使用荟萃分析方法生成了一个森林图，用于比较使用阿替洛尔与其他β受体阻滞剂的患者中，胎儿生长受限的风险比（RR）。使用 I ² 统计量评估统计异质性。
纳入了两项研究，RR 为 1.94 [95%置信区间（CI）1.60；2.35]。2018 年 Duan 等人的一项研究指出了每种β受体阻滞剂使用时胎儿生长受限的发生率如下：阿替洛尔 112/638 例，拉贝洛尔 590/3357 例，美托洛尔 35/324 例，普萘洛尔 50/489 例。2016 年 Tanaka 等人的一项研究指出了胎儿生长受限的发生率如下：普萘洛尔 8/22 例，美托洛尔 2/12 例，阿替洛尔 2/6 例，比索洛尔 0/5 例。异质性（I）为 0%。
与其他β受体阻滞剂（特别是拉贝洛尔、普萘洛尔、比索洛尔和美托洛尔）相比，我们的结果表明使用阿替洛尔与胎儿生长受限的风险增加相关。
