Document Detail


Safety concerns for the use of calcium channel blockers in pregnancy for the treatment of spontaneous preterm labour and hypertension: a systematic review and meta-regression analysis.
MedLine Citation:
PMID:  20180735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Calcium channel blockers (CCBs) are not licensed for use in pregnancy but are used without robust surveillance to treat hypertension in pregnancy and preterm labour. The objective of this study was to evaluate the fetomaternal safety of CCB in pregnancy by a quantitative systematic review.
METHODS: Medline (1996-2005), EMBASE (1996-2003), BIOSIS (1993-2003), Current contents (1995-2003), DERWENT DRUGFILE (1983-2003) and Cochrane Library (2005: issue 3). The number of women reporting an adverse event was used to compute a percentage of the total number of women in whom the occurrence of that event or confirmation of its absence was reported. Meta-regression with generalised estimation equations modelling explored reasons for heterogeneity, seeking factors that increased the rates of the most commonly reported adverse events.
FINDINGS: Of 269 relevant reports, including 5607 women, adverse fetomaternal events varied according to the total dose of nifedipine and study design. Adverse events were highest amongst women given more than 60 mg total dose of nifedipine [odds ratio (OR) 3.78, 95% confidence interval (CI) 1.27-11.2, p = 0.017] and in reports from case series compared to controlled studies (OR 2.45, 95% CI 1.17-5.15, p = 0.018).
INTERPRETATION: Adverse event rates generated from this study provide an evidence base for clinical guidelines and informed patient consent for CCB use in pregnancy.
Authors:
Khalid Khan; Javier Zamora; Ronald F Lamont; Herman Van Geijn Hp; Jens Svare; Carlos Santos-Jorge; Yves Jacquemyn; Peter Husslein; Hanns Helmer H; Joachim Dudenhausen; Gian Carlo Di Renzo; Luis Cabero Roura; Bryan Beattie
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1030-8     Citation Subset:  IM    
Affiliation:
University of Birmingham Women's Hospital, Birmingham UK.
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MeSH Terms
Descriptor/Qualifier:
Calcium Channel Blockers / adverse effects*,  therapeutic use*
Drug Toxicity / epidemiology
Female
Humans
Hypertension, Pregnancy-Induced / drug therapy*,  epidemiology
Infant, Newborn
Obstetric Labor, Premature / drug therapy*,  epidemiology
Pregnancy
Prenatal Exposure Delayed Effects / chemically induced,  epidemiology
Regression Analysis
United States / epidemiology
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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