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α/β- and β-Blocker Exposure in Pregnancy and the Risk of Neonatal Hypoglycemia and Small for Gestational Age

Kana Kubota1,2, Kei Inai1, Eriko Shimada1

  • 1Department of Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women's Medical University.

Circulation Journal : Official Journal of the Japanese Circulation Society
|February 23, 2023
PubMed

Insights

Maternal use of carvedilol during pregnancy increased neonatal hypoglycemia risk. Beta-blockers were linked to more frequent small for gestational age (SGA) infants. Careful monitoring of newborns exposed to these heart medications is crucial.

Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Pharmacology

Background:

  • Congenital heart disease management in pregnant women often involves alpha/beta-blockers and beta-blockers.
  • Limited data exists on the fetal and maternal effects of these medications during pregnancy.
  • This study investigates the risks of neonatal hypoglycemia and small for gestational age (SGA) associated with maternal exposure.

Purpose of the Study:

  • To assess the risks of neonatal hypoglycemia and SGA in infants born to mothers using alpha/beta-blockers or beta-blockers.
  • To compare these risks with a control group of pregnant women with heart disease not on these medications.

Main Methods:

  • A retrospective study included 306 pregnancies (267 women) with heart disease from January 2014 to October 2020.
  • Participants were divided into an alpha/beta-blocker group (carvedilol, n=32), a beta-blocker group (n=11), and a control group (n=263).
  • Outcomes analyzed included neonatal hypoglycemia and SGA.

Main Results:

  • Neonatal hypoglycemia occurred more frequently in the carvedilol group compared to controls (P=0.025).
  • Small for gestational age (SGA) was significantly more common in the beta-blocker group than in the carvedilol and control groups (P<0.001).
  • Carvedilol-associated hypoglycemia was not time- or dose-dependent.

Conclusions:

  • Maternal carvedilol use during pregnancy is associated with an increased risk of neonatal hypoglycemia.
  • Beta-blocker use in pregnancy is linked to a higher incidence of SGA infants.
  • Routine blood glucose monitoring for newborns exposed to alpha/beta-blockers and beta-blockers is recommended.
Abstract

Keywords:
HypoglycemiaPregnancySmall for gestational ageα/β-blockerβ-blocker

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