Anderson Brooke, Elkafrawi Deena, Fochesato Cecilia, Schiattarella Antonio, De Franciscis Pasquale, Sisti Giovanni
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center Permian Basin, Odessa, TX, United States of America.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, SUNY Upstate Medical University, Syracuse, NY, United States of America.
J Turk Ger Gynecol Assoc. 2025 Jun 10;26(2):142-153. doi: 10.4274/jtgga.galenos.2024.2024-1-8.
To assess the efficacy of anti-hypertensive medications during pregnancy according to race, ethnicity and geographical location as current evidence is not clear in this regard. A subgroup meta-analysis of randomized controlled trials was performed. The efficacy of oral medications for chronic hypertension in pregnancy by geographical location [United States of America (USA) vs. rest of the World] was investigated. The location was used as a surrogate of racial identification and differences in health care systems and availability of medications that might affect the efficacy of the treatment. The number of patients in each group experiencing the following outcomes: small for gestational age (SGA), preeclampsia, severe hypertension were compared. Seven studies were identified. Subgroup analysis revealed that medications did not affect the occurrence of SGA. In six studies, therapies were protective for preeclampsia in the rest of the world but not in USA (p=0.02). Therapies were protective for severe hypertension. Our findings suggest that location does not affect the efficacy of medication in treating chronic hypertension during pregnancy. Geographical location may serve as a surrogate for genetic characteristics of a population of interest. However, it can also be influenced by other factors such as the heterogeneity of populations such as the USA.
鉴于目前这方面的证据尚不明确，故根据种族、民族和地理位置评估孕期抗高血压药物的疗效。我们进行了一项随机对照试验的亚组荟萃分析。研究了按地理位置[美国与世界其他地区]划分的孕期慢性高血压口服药物疗效。地理位置被用作种族识别的替代指标，以及可能影响治疗效果的医疗保健系统和药物可及性差异的替代指标。比较了每组中出现以下结局的患者数量：小于胎龄儿（SGA）、先兆子痫、重度高血压。共纳入7项研究。亚组分析显示，药物不影响SGA的发生。在6项研究中，治疗对世界其他地区的先兆子痫有保护作用，但在美国则不然（p=0.02）。治疗对重度高血压有保护作用。我们的研究结果表明，地理位置不影响孕期治疗慢性高血压的药物疗效。地理位置可作为感兴趣人群遗传特征的替代指标。然而，它也可能受到其他因素的影响，如美国等人群的异质性。
