To compare pregnancy outcomes, accounting for allocated group, between methyldopa‐treated and labetalol‐treated women in the
CHIPSTrial ( ISRCTN71416914) of ‘less tight’ versus ‘tight’ control of pregnancy hypertension. Design
Secondary analysis of
CHIPSTrial cohort. Setting
International randomised controlled trial (94 sites, 15 countries).
Population or sample
CHIPSrecruits, 481/566 (85.0%) women treated with antihypertensive therapy at randomisation. Of 981 (99.4%) women followed to delivery, 656/745 (88.1%) treated postrandomisation. Methods
Logistic regression to compare outcomes among women who took methyldopa or labetalol, adjusted for the influence of baseline factors.
Main outcome measures CHIPSprimary (perinatal loss or high level neonatal care for >48 hours) and secondary (serious maternal complications) outcomes, birthweight <10th centile, severe maternal hypertension, pre‐eclampsia and delivery at <34 or <37 weeks. Results
Methyldopa and labetalol were used commonly at randomisation (243/987, 24.6% and 238/987, 24.6%, respectively) and post‐randomisation (224/981, 22.8% and 433/981, 44.1%, respectively). Following adjusted analyses, methyldopa (versus labetalol) at randomisation was associated with fewer babies with birthweight <10th centile [adjusted odds ratio (
aOR) 0.48; 95% CI0.20–0.87]. Methyldopa (versus labetalol) postrandomisation was associated with fewer CHIPSprimary outcomes ( aOR0.64; 95% CI0.40–1.00), birthweight <10th centile ( aOR0.54; 95% CI0.32–0.92), severe hypertension ( aOR0.51; 95% CI0.31–0.83), pre‐eclampsia ( aOR0.55; 95% CI0.36–0.85), and delivery at <34 weeks ( aOR0.53; 95% CI0.29–0.96) or <37 weeks ( aOR0.55; 95% CI0.35–0.85). Conclusion
These nonrandomised comparisons are subject to residual confounding, but women treated with methyldopa (versus labetalol), particularly those with pre‐existing hypertension, may have had better outcomes.
There was no evidence that women treated with methyldopa versus labetalol had worse outcomes.