Gestational Outcomes of Beta Blocker Therapy as a Treatment of Palpitations

Introduction: Beta blocker therapy is considered the primary treatment for palpitations caused by supraventricular or ventricular ectopy. The safety of beta blocker therapy during pregnancy is somewhat controversial and not well studied. Objective: Examine the outcomes of beta blocker therapy for heart palpitations in pregnant women. Methods: We conducted a retrospective review of 3778 pregnant patients between January 2014 and January 2016. The patients’ ages ranged between 18 to 40 years old. 227 patients had complaints of palpitation. 52 patients were eligible for inclusion and were dichotomized into two groups based on their treatment status, Eight patients received treatment with a non-selective beta blocker. The second group did not receive beta blocker therapy. Primary and secondary outcomes based on data collected from the patients’ electronic medical records were compared between the two groups. Results: Beta-blocker exposure during pregnancy was found to be associated with increased risk of small for gestational age (SGA) (OR 7.663, p-value 0.033) as well as a tendency towards increased risk of pregnancy induced hypertension (PIH) (OR 10.87, p-value 0.052). There was no statistical difference in the rates of preterm birth, stillbirth, postpartum haemorrhage, gestational diabetes, need for blood transfusion or the method of delivery between the two groups. Conclusion: The data indicates that exposure to beta-blockers during pregnancy was associated with a significant increase in the risk of both SGA and PIH. This Finding should be explored further with a large randomized controlled trial.