Review: drugs for mild-to-moderate hypertension in pregnancy reduce risk for severe hypertension but not preeclampsia.

M e t h o d s Data sources: Cochrane Pregnancy and Childbirth Group’s Trials Register (March 2006); Cochrane Central Register of Controlled Trials (2005, issue 3); and MEDLINE, LILACS, and EMBASE/Excerpta Medica (to November 2005). Study selection and assessment: Randomized controlled trials (RCTs) that evaluated any antihypertensive drug (compared with placebo or no antihypertensive drug [control] or another type of antihypertensive drug) for mild-to-moderate hypertension (systolic blood pressure [BP] 140 to 169 mm Hg and diastolic BP 90 to 109 mm Hg) during pregnancy. Quasi-randomized studies and those involving treatment for < 7 days were excluded. 46 RCTs (n = 4282) met the selection criteria: 28 RCTs compared antihypertensive drugs with control (n = 3200) and 19 RCTs compared 2 types of antihypertensive drugs (n = 1282). Quality of individual trials was assessed based on allocation concealment, blinding, and withdrawals. Outcomes: Severe hypertension, preeclampsia, fetal or neonatal death, preterm birth, and small-for-gestational age (SGA) infants.