From: Evidence review for interventions for chronic hypertension
Copyright © NICE 2019.
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National Guideline Alliance (UK). Evidence review for interventions for chronic hypertension: Hypertension in pregnancy: diagnosis and management: Evidence review A. London: National Institute for Health and Care Excellence (NICE); 2019 Jun. (NICE Guideline, No. 133.)
Evidence review for interventions for chronic hypertension: Hypertension in pregnancy: diagnosis and management: Evidence review A.
Show detailsTable 11Clinical evidence profile. Comparison 7. Labetalol versus methyldopa
| Quality assessment | Number of patients | Effect | Quality | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Labetalol | Methyldopa | Relative (95% CI) | Absolute | ||
| Stillbirth | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | no serious imprecision | none |
0/38 (0%) |
0/34 (0%) | not calculable | not calculable | VERY LOW | CRITICAL |
| Neonatal death | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | very serious3 | none |
2/38 (5.3%) |
0/34 (0%) | RR 4.49 (0.22 to 90.30)6 | - | VERY LOW | CRITICAL |
| Small for gestational age | ||||||||||||
| 2 (Moore 1982, Sibai 1990) | randomised trials | very serious1 | no serious inconsistency | serious2 | very serious3 | none |
20/124 (16.1%) |
21/122 (17.2%) | RR 0.89 (0.53 to 1.49) | 19 fewer per 1000 (from 81 fewer to 84 more) | VERY LOW | CRITICAL |
| Birth weight (grams) (Better indicated by higher values) | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | no serious imprecision | none | 38 | 34 | - | MD 7 higher (363.32 lower to 377.32 higher) | VERY LOW | IMPORTANT |
| Gestational age at birth (weeks) (Better indicated by higher values) | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | no serious imprecision | none | 38 | 34 | - | MD 0.1 higher (1.2 lower to 1.4 higher) | VERY LOW | IMPORTANT |
| Admission to neonatal unit | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | very serious3 | none |
19/38 (50%) |
16/34 (47.1%) | RR 1.06 (0.66 to 1.71) | 28 more per 1000 (from 160 fewer to 334 more) | VERY LOW | IMPORTANT |
| Maximum sBP after entry (mmHg) (Better indicated by lower values) | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | serious4 | none | 38 | 34 | - | MD 2.7 higher (5.82 lower to 11.22 higher) | VERY LOW | CRITICAL |
| Maximum dBP after entry (mmHg) (Better indicated by lower values) | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | serious5 | none | 38 | 34 | - | MD 0.9 lower (5.99 lower to 4.19 higher) | VERY LOW | CRITICAL |
| Onset of labour (induction) | ||||||||||||
| 1 (Moore 1982) | randomised trials | very serious1 | no serious inconsistency | serious2 | very serious3 | none |
20/38 (52.6%) |
14/34 (41.2%) | RR 1.28 (0.77 to 2.11) | 115 more per 1000 (from 95 fewer to 457 more) | VERY LOW | IMPORTANT |
| Mode of birth (C-section) | ||||||||||||
| 2 (Moore 1982, Sibai 1990) | randomised trials | very serious1 | no serious inconsistency | serious2 | very serious3 | none |
49/124 (39.5%) |
51/122 (41.8%) | RR 0.93 (0.69 to 1.26) | 29 fewer per 1000 (from 130 fewer to 109 more) | VERY LOW | IMPORTANT |
- 1
The quality of the evidence was downgraded by 2 levels due to an unclear risk of random sequence generation, allocation concealment, performance and selection bias, and selective reporting
- 2
The quality of the evidence was downgraded by 1 level as 34.8% of participants did not present with chronic hypertension
- 3
The quality of the evidence was downgraded by 2 levels as the 95% CI crossed 2 default MID thresholds (0.8 and 1.25)
- 4
The quality of the evidence was downgraded by 1 level as the 95% CI crossed 1 MID threshold (14.9 × +/− 0.5 = +/− 7.45)
- 5
The quality of the evidence was downgraded by 1 level as the 95% CI crossed 1 default MID threshold (9.1 × +/− 0.5 = +/−4.55)
- 6
The corresponding absolute risk was not calculated as there were no events reported in the control arm.
- Chronic hypertension: first-trimester blood pressure control and likelihood of severe hypertension, preeclampsia, and small for gestational age.[Am J Obstet Gynecol. 2018]Chronic hypertension: first-trimester blood pressure control and likelihood of severe hypertension, preeclampsia, and small for gestational age.Nzelu D, Dumitrascu-Biris D, Nicolaides KH, Kametas NA. Am J Obstet Gynecol. 2018 Mar; 218(3):337.e1-337.e7. Epub 2018 Jan 2.
- Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy.[Cochrane Database Syst Rev. 2019]Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy.Hofmeyr GJ, Manyame S, Medley N, Williams MJ. Cochrane Database Syst Rev. 2019 Sep 16; 9(9):CD011192. Epub 2019 Sep 16.
- The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.[JBI Database System Rev Implem...]The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.Spencer L, Rollo M, Hauck Y, MacDonald-Wicks L, Wood L, Hutchesson M, Giglia R, Smith R, Collins C. JBI Database System Rev Implement Rep. 2015 Jan; 13(1):88-98.
- Review Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.[Cochrane Database Syst Rev. 2001]Review Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Cochrane Database Syst Rev. 2001; (2):CD002252.
- Review Evidence review for monitoring gestational hypertension: Hypertension in pregnancy: diagnosis and management: Evidence review B[ 2019]Review Evidence review for monitoring gestational hypertension: Hypertension in pregnancy: diagnosis and management: Evidence review BNational Guideline Alliance (UK). 2019 Jun
- Table 11, Clinical evidence profile. Comparison 7. Labetalol versus methyldopa -...Table 11, Clinical evidence profile. Comparison 7. Labetalol versus methyldopa - Evidence review for interventions for chronic hypertension
- nipped-B-like protein isoform B [Homo sapiens]nipped-B-like protein isoform B [Homo sapiens]gi|47578107|ref|NP_056199.2|Protein
- Homo sapiens NIPBL cohesin loading factor (NIPBL), transcript variant B, mRNAHomo sapiens NIPBL cohesin loading factor (NIPBL), transcript variant B, mRNAgi|1675178204|ref|NM_015384.5|Nucleotide
- Homo sapiens replication factor C (activator 1) 1, 145kDa, mRNA (cDNA clone MGC:...Homo sapiens replication factor C (activator 1) 1, 145kDa, mRNA (cDNA clone MGC:9024 IMAGE:3923331), complete cdsgi|23273760|gb|BC035297.1|Nucleotide
- ACSBG1 [Balearica regulorum gibbericeps]ACSBG1 [Balearica regulorum gibbericeps]Gene ID:104641537Gene
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