The Risk for Neonatal Hypoglycemia and Bradycardia after Beta-Blocker Use during Pregnancy or Lactation: A Systematic Review and Meta-Analysis

Rosalie de Bruin, Sarah L. van Dalen, Shamaya J. Franx, Viraraghavan V. Ramaswamy, Sinno H. P. Simons, Robert B. Flint and Gerbrich E. van den Bosch
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Rosalie de Bruin: Faculty of Medicine, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands
Sarah L. van Dalen: Faculty of Medicine, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands
Shamaya J. Franx: Faculty of Medicine, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands
Viraraghavan V. Ramaswamy: Department of Neonatology, Ankura Hospital for Women and Children, Hyderabad 500072, Telangana, India
Sinno H. P. Simons: Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands
Robert B. Flint: Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands
Gerbrich E. van den Bosch: Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, 3015GD Rotterdam, The Netherlands

IJERPH, 2022, vol. 19, issue 15, 1-43

Abstract: Beta-blockers are often used during pregnancy to treat cardiovascular diseases. The described neonatal side effects of maternal beta-blocker use are hypoglycemia and bradycardia, but the evidence base for these is yet to be evaluated comprehensively. Hence, this systematic review and meta-analysis was performed to evaluate the potential increased risk for hypoglycemia and bradycardia in neonates exposed to beta-blockers in utero or during lactation. A systematic search of English-language human studies was conducted until 21 April 2021. Both observational studies and randomized controlled trials investigating hypoglycemia and/or bradycardia in neonates following beta-blocker exposure during pregnancy and lactation were included. All articles were screened by two authors independently and eligible studies were included. Pair-wise and proportion-based meta-analysis was conducted and the certainty of evidence (CoE) was performed by standard methodologies. Of the 1.043 screened articles, 55 were included in this systematic review. Our meta-analysis showed a probable risk of hypoglycemia (CoE—Moderate) and possible risk of bradycardia (CoE—Low) in neonates upon fetal beta-blocker exposure. Therefore, we suggest the monitoring of glucose levels in exposed neonates until 24 h after birth. Due to the limited clinical implication, monitoring of the heart rate could be considered for 24 h. We call for future studies to substantiate our findings.

Keywords: beta-blockers; bradycardia; hypoglycemia; lactation; neonate; pregnancy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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