Intra-uterine growth retardation and maternal labetatol treatment in a random allocation controlled study

Summary

Summary

Intra-uterine growth retardation (IUGR) is the main contributory factor in the increased perinatal morbidity and mortality associated with pregnancy induced hypertension. Seventy-six primigravidae and 38 parous women with non-proteinuric hypertension (diastolic blood pressure >90mmHg) and singleton pregnancies were allocated at random to receive either labetalol or no anti-hypertensive treatment. At recruitment maternal age, blood pressure and gestational age were similar in both treatment and control groups. For primigravidae 16 per cent (7/45) of the controls delivered a baby with weight less than the 10th centile for gestational age compared with 19 per cent (6/31) in the labetalol treated group. A birth weight less than the 10th centile for gestational age occurred in 2 out of 18 multigravid controls and 4 out of 20 of the multigravid labetalol treated group. There were more admissions to the neonatal unit for the babies of labetalol treated mothers.

A limited meta-analysis of the results combined with those of two other controlled trials suggests that the drug contributes to intra-uterine growth retardation (P<0·05).

The possibility of labetalol having a direct adverse effect on fetal growth requires further evaluation in a larger random controlled study.