| Research question | In women who require treatment for hypertension in pregnancy, what are the adverse neonatal outcomes associated with maternal use of beta-blockers (or mixed alpha/beta-blockers)? |
|---|---|
| Importance to ‘patients’ or the population | Further studies would clarify if beta or mixed alpha/beta-blockers are associated with neonatal hypoglycaemia and may reduce or eliminate the need for invasive heel prick testing to monitor blood glucose in some or all of these babies. |
| Relevance to NICE guidance | The committee searched for evidence on this topic but found no high-quality evidence. Clinical studies in this area would allow more definitive evidence-based recommendations to be made. |
| Relevance to the NHS | Clear recommendations in this area would reduce the likelihood of morbidity and separation of woman and baby in the immediate postnatal period. |
| National priorities | The Department of Health and Social Care Single Departmental Plan (May 2018) aims to reduce the 2010 rate of neonatal deaths and brain injuries in babies that occur during or soon after birth by 20% by 2020 and 50% by 2025 |
| Current evidence base | A systematic review published in 2016 found that there is an increased risk of neonatal blood glucose levels falling below 2.6mmol/L shortly after birth if their mothers received beta blockers or labetalol, a mixed alpha and beta blocker in late pregnancy. However, it is physiological for a newborn’s blood glucose level to fall below this threshold in the immediate postnatal period. This systematic review does not address whether these neonatal blood glucose levels below 2.6mmol/L were associated with any clinical problems or long-term morbidity. |
| Equality | Babies born to women with hypertension in pregnancy are entitled to safe care without risk of long term morbidity. |
From: Evidence review for interventions for chronic hypertension
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