Treatment of hypertension, including use of contraindicated drugs, is common during pregnancy
Pregnant women are commonly exposed to antihypertensive medications, including in some instances medications that are considered contraindicated in pregnancy, according to a new study. Using data for women insured through Medicaid from 2002 to 2007, which covers approximately 40 percent of all pregnancies in the United States, the researchers identified 48,453 Medicaid-insured women who were exposed to antihypertensive medications during pregnancy (4.4 percent of the group).
The prevalence of exposure to antihypertensive drugs at any time during pregnancy increased from 3.5 percent of the entire group in 2000 to 4.9 percent in 2006. Over the entire time period, 1.9 percent of the group had antihypertensive drug exposure during the first trimester, 1.7 percent during the second trimester, and 3.2 percent during the third trimester.
Despite professional guidelines recommending methyldopa and labetalol as the first-line treatments for hypertension during pregnancy, many other agents were commonly used, some of which are considered contraindicated in pregnancy. The study was funded in part by AHRQ HS18533).
More details are in "Patterns of outpatient antihypertensive medication use during pregnancy in a Medicaid population," by Brian T. Bateman, M.D., Sonia Hernandez-Diaz, M.D., M.P.H., Dr.P.H., Krista F. Huybrechts, M.S., Ph.D., and others in the October 2012 Hypertension 60(4), pp. 913-920.