TY - JOUR
T1 - Neurocognitive development of children following in-utero exposure to labetalol for maternal hypertension
T2 - A cohort study using a prospectively collected database
AU - Chan, Wee Shian
AU - Koren, Gideon
AU - Barrera, Maru
AU - Rezvani, Massoud
AU - Knittel-Keren, Dafna
AU - Nulman, Irena
N1 - Funding Information:
The authors report no conflicts of interest. Funding was received from the Canadian Foundation for Women’s Health. The authors alone are responsible for the content and writing of this paper. Preliminary findings were presented at the 47th annual meeting of the Teratology Society, which took place on June 23–28, 2007 in Pittsburgh Pennsylvania. The abstract was published in Birth Defects Research (Part A) 79:405–426 (2007), which has been submitted along with the manuscript.
PY - 2010/8
Y1 - 2010/8
N2 - Objective: To identify the effect of prenatal labetalol exposure on children's long-term neurodevelopment. Design: A cohort study with matched controls using a prospectively collected database. Methods: Participants were women counseled for hypertension in pregnancy at the Motherisk Program at The Hospital for Sick Children, and The Sunnybrook Health Sciences Centre, Toronto, Canada and their children. Mother-child pairs were divided into groups based on in-utero exposure to labetalol (n 32), non-teratogenic substances (n 42), and methyldopa (n 25). The main outcome measures were children's Full-Scale IQ, Performance IQ and Verbal IQ assessed with the Wechsler Preschool and Primary Scale of Intelligence. Results: There were no statistically significant differences in scores on Full-Scale IQ, Performance IQ, or Verbal IQ between children exposed in utero to labetalol and to non-teratogenic substances (Full-Scale IQ: 109.60 ± 8.20 vs. 111.90 ± 11.39, p 0.647; Performance IQ: 104.80 ± 8.69 vs. 110.19 ± 12.91, p 0.186; Verbal IQ: 112.27 ± 11.05 vs. 11.21 ± 11.98, p 0.922, respectively). Children in the methyldopa group achieved lower scores on measures of Full-Scale IQ and Performance IQ when compared to children exposed to non-teratogenic substances (Full-Scale IQ: 105.24 ± 12.46 vs. 111.90 ± 11.39, p 0.043; Performance IQ: 98.80 ± 16.16 vs. 110.19 ± 12.91, p 0.002, respectively). Linear regression analysis revealed that maternal Full Scale IQ was a significant predictor of children's Full-Scale IQ (p 0.020, beta 0.229). Maternal Performance IQ and duration of treatment with methyldopa were significant predictors of children's Performance IQ (p 0.028, beta 0.232; p 0.16, beta 0.255, respectively). Conclusion: In-utero exposure to labetalol does not appear to adversely affect the neurocognitive development of young children. These reassuring results may aid disease management for pregnant women with hypertension.
AB - Objective: To identify the effect of prenatal labetalol exposure on children's long-term neurodevelopment. Design: A cohort study with matched controls using a prospectively collected database. Methods: Participants were women counseled for hypertension in pregnancy at the Motherisk Program at The Hospital for Sick Children, and The Sunnybrook Health Sciences Centre, Toronto, Canada and their children. Mother-child pairs were divided into groups based on in-utero exposure to labetalol (n 32), non-teratogenic substances (n 42), and methyldopa (n 25). The main outcome measures were children's Full-Scale IQ, Performance IQ and Verbal IQ assessed with the Wechsler Preschool and Primary Scale of Intelligence. Results: There were no statistically significant differences in scores on Full-Scale IQ, Performance IQ, or Verbal IQ between children exposed in utero to labetalol and to non-teratogenic substances (Full-Scale IQ: 109.60 ± 8.20 vs. 111.90 ± 11.39, p 0.647; Performance IQ: 104.80 ± 8.69 vs. 110.19 ± 12.91, p 0.186; Verbal IQ: 112.27 ± 11.05 vs. 11.21 ± 11.98, p 0.922, respectively). Children in the methyldopa group achieved lower scores on measures of Full-Scale IQ and Performance IQ when compared to children exposed to non-teratogenic substances (Full-Scale IQ: 105.24 ± 12.46 vs. 111.90 ± 11.39, p 0.043; Performance IQ: 98.80 ± 16.16 vs. 110.19 ± 12.91, p 0.002, respectively). Linear regression analysis revealed that maternal Full Scale IQ was a significant predictor of children's Full-Scale IQ (p 0.020, beta 0.229). Maternal Performance IQ and duration of treatment with methyldopa were significant predictors of children's Performance IQ (p 0.028, beta 0.232; p 0.16, beta 0.255, respectively). Conclusion: In-utero exposure to labetalol does not appear to adversely affect the neurocognitive development of young children. These reassuring results may aid disease management for pregnant women with hypertension.
KW - Child neurodevelopment
KW - Hypertension
KW - Labetalol
KW - Methyldopa
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=77955111507&partnerID=8YFLogxK
U2 - 10.3109/10641950902777705
DO - 10.3109/10641950902777705
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C2 - 20670152
AN - SCOPUS:77955111507
SN - 1064-1955
VL - 29
SP - 271
EP - 283
JO - Hypertension in Pregnancy
JF - Hypertension in Pregnancy
IS - 3
ER -