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Maternal hypertension, antihypertensive medication use, and small for gestational age births in the National Birth Defects Prevention Study, 1997-2011
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2 2018
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Source: Matern Child Health J. 22(2):237-246
[PDF-424.73 KB]
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Alternative Title:Matern Child Health J
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Description:Background:
Small for gestational age (SGA) birth is associated with poor long-term health outcomes. It is unclear whether maternal antihypertensive medication increases risk of SGA independently of maternal hypertension.
Methods:
We analyzed associations between maternal hypertension and antihypertensive medication use and SGA among non-malformed singleton controls in the National Birth Defects Prevention Study. We defined SGA as birthweight<10th percentile for a given gestational age, sex, race/ethnicity, and parity. We included 1,045 SGA and 10,019 non-SGA births. We used logistic regression to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). We assessed interaction between hypertension, antihypertensive medication use, and maternal race/ethnicity and age.
Results:
Overall, 122 (11.7%) SGA and 892 (8.9%) non-SGA mothers reported hypertension and 21 (2.0%) SGA and 154 (1.5%) non-SGA mothers reported antihypertensive medication use. The most commonly reported medications were centrally-acting antiadrenergics, β-blockers, calcium channel blockers, and diuretics. Compared to normotensive pregnancies, maternal hypertension, regardless of treatment (AOR, 1.49 [95% CI, 1.20, 1.86]), and untreated maternal hypertension (AOR, 1.46 [95% CI, 1.15, 1.86]) were associated with SGA. We observed a positive, but not significant, association between antihypertensive medication use and SGA. SGA risk varied by maternal race/ethnicity, being highest among Hispanic mothers, and age, being highest among mothers ≥35 years, but statistical tests for interaction were not significant.
Conclusions:
Consistent with the literature, our findings suggest that maternal hypertension slightly increases SGA risk. We did not find an appreciably increased SGA risk associated with antihypertensive medication use beyond that of the underlying maternal hypertension.
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Pubmed ID:29124624
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Pubmed Central ID:PMC10068427
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