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    Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy

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    Authors
    Davis, Robert L.
    Eastman, David
    McPhillips, Heather
    Raebel, Marsha A.
    Andrade, Susan E.
    Smith, David H.
    Yood, Marianne Ulcickas
    Dublin, Sascha
    Platt, Richard
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2011-02-22
    Keywords
    Abnormalities, Drug-Induced
    Adolescent
    Adrenergic beta-Antagonists
    Adult
    Calcium Channel Blockers
    Drug Prescriptions
    Female
    Health Maintenance Organizations
    Humans
    Hypoglycemia
    Infant, Newborn
    Insurance, Pharmaceutical Services
    Pregnancy
    Pregnancy Trimester, Third
    *Prenatal Exposure Delayed Effects
    Retrospective Studies
    Risk Assessment
    Risk Factors
    Seizures
    Time Factors
    United States
    Young Adult
    Health Services Research
    Primary Care
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    Link to Full Text
    http://dx.doi.org/10.1002/pds.2068
    Abstract
    PURPOSE: Calcium channel blockers and beta-blockers (BBs) are widely used during pregnancy, but data on their safety for the developing infant are scarce. We used population-based data from 5 HMOs to study risks for perinatal complications and congenital defects among infants exposed in-utero. METHODS: We studied women older than 15 years delivering an infant between 1/1/96 and 12/31/00, who had been continuously enrolled with prescription drug coverage for >/= 1 year prior to delivery. Information on prescription drug dispensings, inpatient, and outpatient diagnoses and procedures was obtained from automated databases at each HMO. RESULTS: There were 584 full-term infants exposed during pregnancy to BBs and 804 full-term infants exposed to calcium-channel blockers, and over 75,000 unexposed mother-infant pairs with >/= 30 days follow-up. Infants exposed to BBs in the third trimester of pregnancy had over threefold increased risk for hypoglycemia (RR 3.1; 95% CI 2.2, 4.2) and an approximately twofold increased risk for feeding problems (RR 1.8; 95% CI 1.3, 2.5). Infants exposed to calcium-channel blockers in the third trimester had an increased risk for seizures (RR 3.6 95% CI 1.3, 10.4). Chart review confirmed the majority of the exposed seizure and hypoglycemia cases. There were no increased risks for congenital anomalies among either group of infants, except for the category of upper alimentary tract anomalies; this increased risk was based on only two exposed cases. CONCLUSIONS: Infants whose mothers receive BBs are at increased risk for neonatal hypoglycemia, while those whose mothers take calcium-channel blockers are at increased risk for neonatal seizures.
    Source
    Pharmacoepidemiol Drug Saf. 2011 Feb;20(2):138-45. doi: 10.1002/pds.2068. Epub 2010 Nov 15. Link to article on publisher's site
    DOI
    10.1002/pds.2068
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/36887
    PubMed ID
    21254284
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/pds.2068
    Scopus Count
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