Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011

Sarah C Fisher; Alissa R Van Zutphen; Paul A Romitti; Marilyn L Browne; National Birth Defects Prevention Study

doi:10.1007/s10995-017-2395-8

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Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011

Journal article

Peer reviewed

Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011

Sarah C Fisher, Alissa R Van Zutphen, Paul A Romitti, Marilyn L Browne and National Birth Defects Prevention Study

Maternal and child health journal, Vol.22(2), pp.237-246

02/2018

DOI: 10.1007/s10995-017-2395-8

PMID: 29124624

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10068427/pdf/nihms-1874068.pdfView

Open Access

Abstract

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 1045 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 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 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 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 observe an appreciably increased SGA risk associated with antihypertensive medication use beyond that of the underlying maternal hypertension.

Pregnancy

Pre-Eclampsia - epidemiology

Humans

Hypertension - drug therapy

Treatment Outcome

Antihypertensive Agents - therapeutic use

Gestational Age

Mothers

Case-Control Studies

Hypertension, Pregnancy-Induced - drug therapy

Pregnancy Outcome - epidemiology

Socioeconomic Factors

Antihypertensive Agents - adverse effects

Maternal Age

Hypertension, Pregnancy-Induced - epidemiology

Adult

Female

Infant, Small for Gestational Age

Retrospective Studies

Hypertension - epidemiology

Infant, Newborn

Details

Title: Subtitle: Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997-2011
Creators: Sarah C Fisher - Congenital Malformations Registry, New York State Department of Health, Albany, NY, USA. sarah.fisher@health.ny.gov
Alissa R Van Zutphen - Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA
Paul A Romitti - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
Marilyn L Browne - Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA
National Birth Defects Prevention Study
Resource Type: Journal article
Publication Details: Maternal and child health journal, Vol.22(2), pp.237-246
DOI: 10.1007/s10995-017-2395-8
PMID: 29124624
NLM abbreviation: Matern Child Health J
ISSN: 1092-7875
eISSN: 1573-6628
Publisher: United States
Grant note: Cooperative Agreement U01DD001032 / CDC HHS P30 ES005605 / NIEHS NIH HHS
Language: English
Date published: 02/2018
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9983995165102771

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