ANTI-HYPERTENSIVE DRUGS IN PREGNANCY AND FETAL GROWTH: EVIDENCE FOR “PHARMACOLOGICAL PROGRAMMING” IN THE FIRST TRIMESTER?

Abstract

Atenolol taken at the time of conception and/or during the first trimester of pregnancy was associated with low birth weight. This finding was independent of the development of superimposed pre-eclampsia. Other anti-hypertensives were not found to be associated with low birth weight. Use of atenolol in the second trimester of pregnancy did not produce the same effect and was not materially different in its effects from the other anti-hypertensive drugs. In the second trimester, the development of superimposed pre-eclampsia is the over-riding effect in the reduction of infant birth weight. Atenolol used in the first trimester could be pharmacologically programming these infants to restricted growth patterns.