Antihypertensive medication use during pregnancy in a real-world cohort of patients diagnosed with a hypertensive disorder of pregnancy

Hypertensive disorders of pregnancy (HDP) are rising in prevalence and associated with adverse maternal infant health outcomes. Current guidelines recommend labetalol, nifedipine, methyldopa as acceptable first-line agents to treat HDP outpatient settings. However, the current practice regarding antihypertensive medication usage selection remain unclear. A retrospective, observational cohort study was conducted 1,641 patients a physician diagnosis who delivered at two academic medical centers North Carolina from 2014 2017. Use any medication, agent selected, encounter during or on delivery date collected electronic record. Proportions were compared across (eclampsia/severe preeclampsia, chronic hypertension superimposed gestational hypertension) by Chi-square tests multivariable logistic regression. Antihypertensive medications used 1,276 (77.8%) overall. Among treated patients, labetalol (74.9%) most frequently followed nifedipine (29.6%) hydralazine (20.5%). Methyldopa infrequently (4.4%). type strongest factor use an agent. Relative hypertension, significantly more likely [odds ratio (95% CI)] severe preeclampsia [5.94 (3.85–9.16)], [4.99 (3.46–7.19)], [2.13 (1.61–2.82)]. In real-world setting, among common, commonly selected agents, increasing severity higher likelihood use. Future studies comparing effectiveness pregnant distinct diagnoses needed.