Beta-blockers (All routes except ocular) (versus unexposed)

Table   Graphic  
individual studies
OutcomeTE95% CIn casesn exposedkPub. bias Congenital malformations All congenital malformations (majors, minors, majors and minors, or unspecified) Queisser-Luft - Beta-blockers, 1996 Nakhai-Pour - Beta-blockers, 2010 Vasilakis-Scaramozza - Beta-blockers, 2013 Bateman_USMAX - Beta-blockers, 2018 Hoeltzenbein c - Bisoprolol, 2018 Bateman_Nordic - Beta-blockers, 2018 Delteil - Beta-blockers, 2024 71.16[0.99; 1.35]10,5893,875not evaluable Congenital heart defects Cedergren - Beta-blockers, 2002 Lennestal - Beta-blockers, 2009 Duan - Beta-blockers, 2017 Fisher - Beta-blockers (Controls unexposed, sick), 2017 Bateman_Nordic - Beta-blockers, 2018 Bateman_USMAX - Beta-blockers, 2018 Bergman - Beta-blockers, 2018 Delteil - Beta-blockers, 2024 81.28[0.95; 1.72]53,9077,098not evaluable Major congenital malformations Queisser-Luft - Beta-blockers, 1996 Nakhai-Pour - Beta-blockers, 2010 Vasilakis-Scaramozza - Beta-blockers, 2013 Bateman_USMAX - Beta-blockers, 2018 Hoeltzenbein c - Bisoprolol, 2018 Bateman_Nordic - Beta-blockers, 2018 Delteil - Beta-blockers, 2024 71.16[0.99; 1.35]10,5893,875not evaluable Atrial septal defect Duan - Beta-blockers, 2017 Fisher - Beta-blockers (Controls unexposed, sick), 2017 Bergman - Beta-blockers, 2018 31.34[0.93; 1.92]9,7252,859not evaluable Oro-facial clefts Bateman_Nordic - Beta-blockers, 2018 Bateman_USMAX - Beta-blockers, 2018 Delteil - Beta-blockers, 2024 31.74[0.72; 4.17]1763,324not evaluable Cleft palate Puho - Metoprolol, 2007 Fisher a - Beta-blockers, 2018 Bergman - Beta-blockers, 2018 31.47[0.92; 2.33]4,055274not evaluable Coarctation of aorta Duan - Beta-blockers, 2017 Fisher - Beta-blockers (Controls unexposed, sick), 2017 21.72[0.87; 3.40]2232,677not evaluable Genital anomalies Vasilakis-Scaramozza - Beta-blockers, 2013 Delteil - Beta-blockers, 2024 21.74[0.72; 4.22]4101,189not evaluable Limb defects Queisser-Luft - Beta-blockers, 1996 Vasilakis-Scaramozza - Beta-blockers, 2013 Delteil - Beta-blockers, 2024 31.99[0.92; 4.28]4831,189not evaluable Ventricular septal defect Duan - Beta-blockers, 2017 Fisher - Beta-blockers (Controls unexposed, sick), 2017 21.83[0.41; 8.12]2,7812,630not evaluable Atresia or stenosis of other parts of small intestine Fisher a - Beta-blockers, 2018 Bergman - Beta-blockers, 2018 22.45[1.17; 5.13]852-not evaluable Chromosomal abnormalities Delteil - Beta-blockers, 2024 10.66[0.17; 2.67]514974not evaluable Cleft lip with or without cleft palate Puho - Oxprenolol, 2007 Bergman - Beta-blockers, 2018 22.08[0.56; 7.72]5,006198not evaluable Diaphragmatic hernia Fisher a - Beta-blockers, 2018 Bergman - Beta-blockers, 2018 21.37[0.65; 2.89]1,664-not evaluable Digestive system anomalies Queisser-Luft - Beta-blockers, 1996 Delteil - Beta-blockers, 2024 22.10[0.36; 12.23]199974not evaluable Ear, face and neck anomalies Delteil - Beta-blockers, 2024 11.59[0.10; 25.79]53974not evaluable Eye defects Delteil - Beta-blockers, 2024 10.69[0.04; 11.08]123974not evaluable Hydrocephaly Fisher a - Beta-blockers, 2018 Bergman - Beta-blockers, 2018 20.88[0.40; 1.91]2,420-not evaluable Hypoplastic left heart (HLH/HLHS) Fisher - Beta-blockers (Controls unexposed, sick), 2017 10.92[0.27; 3.16]-44not evaluable Hypospadias Van Zutphen - Beta-blockers, 2014 Bergman - Beta-blockers, 2018 21.32[0.60; 2.90]10,30260not evaluable Nervous system anomalies Bateman_USMAX - Beta-blockers, 2018 Delteil - Beta-blockers, 2024 21.21[0.58; 2.52]4162,642not evaluable Neural Tube Defects Medveczky - Pindolol, 2004 Bergman - Beta-blockers, 2018 21.84[0.23; 14.52]5,096158not evaluable Oesophageal atresia with or without tracheo-oesophageal fistula Fisher a - Beta-blockers, 2018 Bergman - Beta-blockers, 2018 21.20[0.50; 2.85]1,411-not evaluable Pulmonary valve stenosis Fisher - Beta-blockers (Controls unexposed, sick), 2017 12.05[1.08; 3.89]-8not evaluable Respiratory system anomalies Delteil - Beta-blockers, 2024 14.06[0.56; 29.50]43974not evaluable Spina bifida Fisher a - Beta-blockers, 2018 11.00[0.39; 2.55]1,164-not evaluable Total anomalous pulm venous return Fisher - Beta-blockers (Controls unexposed, sick), 2017 14.21[0.92; 19.30]-43not evaluable Urinary malformations Delteil - Beta-blockers, 2024 12.48[1.40; 4.40]841974not evaluable Abdominal wall defects Delteil - Beta-blockers, 2024 11.22[0.08; 19.79]69974not evaluable Ano-rectal atresia and stenosis Fisher a - Beta-blockers, 2018 10.80[0.28; 2.31]784-not evaluable Anotia Fisher a - Beta-blockers, 2018 11.30[0.43; 3.95]628-not evaluable Club foot / Talipes equinovarus Bergman - Beta-blockers, 2018 11.00[0.56; 1.78]4,4133not evaluable Congenital constriction bands/amniotic band Syvanen - Beta-blockers, 2021 124.20[2.57; 228.04]1065not evaluable Congenital hydronephrosis Bergman - Beta-blockers, 2018 10.70[0.34; 1.46]4,993-not evaluable Craniosynostosis Fisher a - Beta-blockers, 2018 11.00[0.40; 2.50]1,412-not evaluable Ebstein's anomaly Caton - Beta-blockers, 2009 18.10[0.47; 139.00]6511not evaluable Gastroschisis Fisher a - Beta-blockers, 2018 10.50[0.13; 1.94]1,327-not evaluable Hip dislocation and/or dysplasia Bergman - Beta-blockers, 2018 10.60[0.29; 1.25]4,670-not evaluable Limb reduction defects (LRD) Bergman - Beta-blockers, 2018 10.60[0.19; 1.85]1,832-not evaluable Microcephaly / Small head circumference for gestational age Bergman - Beta-blockers, 2018 12.00[0.79; 5.05]957-not evaluable Minor congenital malformations 0----- Multicystic renal dysplasia Bergman - Beta-blockers, 2018 12.50[1.26; 4.95]1,334-not evaluable Patent ductus arterious Duan - Beta-blockers, 2017 11.00[0.76; 1.32]4,1792,628not evaluable Polydactyly Bergman - Beta-blockers, 2018 10.50[0.21; 1.17]3,717-not evaluable Single ventricle Duan - Beta-blockers, 2017 11.30[0.42; 4.06]1712,628not evaluable Syndactyly Bergman - Beta-blockers, 2018 10.60[0.19; 1.85]1,784-not evaluable Vascular disruption anomalie 0----- Growth parameters and prematurity Small for gestational age (weight) Lieberman - Propranolol, 1978 Rosenfeld - Pindolol, 1986 Cruickshank - Labetalol, 1990 Lydakis - Atenolol, 1999 Ray - Beta-blockers, 2001 Bayliss - Atenolol, 2002 Nakhai-Pour - Beta-blockers, 2010 Petersen - Beta-blockers, 2012 Orbach - Atenolol, 2013 Su - Beta-blockers (Controls unexposed, sick) , 2013 Ersboll - Beta-blockers (Controls unexposed, sick), 2014 Tanaka - Beta-blockers, 2016 Thewissen - Labetalol (Controls unexposed, sick), 2017 Duan - Beta-blockers, 2018 Fisher b - Beta-blockers (Controls unexposed, sick), 2018 Gandjbakhch - Beta-blockers, 2018 Mazkereth - Beta-blockers, 2019 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Kayser - Metoprolol/bisoprolol, 2020 Kumar - Beta-blockers, 2020 Baard - Beta-blockers, 2020 Xiang - Labetalol, 2020 Al Khalaf - Beta-blockers (Controls unexposed, sick), 2022 Kubota - Beta-blockers, 2023 Albertini - Beta-blockers, 2023 Delteil - Beta-blockers, 2024 262.02[1.68; 2.43]153,52812,867low Preterm (< 37 weeks) Rosenfeld - Pindolol, 1986 Cruickshank - Labetalol, 1991 Lydakis - Atenolol, 1999 Ray - Beta-blockers, 2001 Petersen - Beta-blockers, 2012 Su - Beta-blockers (Controls unexposed, sick) , 2013 Orbach - Atenolol, 2013 Tanaka - Beta-blockers, 2016 Ishibashi - Beta-blockers, 2017 Gandjbakhch - Beta-blockers, 2018 Kayser - Metoprolol/bisoprolol, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Baard - Beta-blockers, 2020 Xiang - Labetalol, 2020 Al Khalaf - Beta-blockers (Controls unexposed, sick), 2022 Delteil - Beta-blockers, 2024 Vaclavik - Beta-blockers, 2024 171.78[1.49; 2.13]126,9177,825low Low birth weight (< 2500g) Rosenfeld - Pindolol, 1986 Su - Beta-blockers (Controls unexposed, sick) , 2013 Orbach - Atenolol, 2013 Ishibashi - Beta-blockers, 2017 Duan - Beta-blockers, 2018 Baard - Beta-blockers, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Vaclavik - Beta-blockers, 2024 82.24[1.48; 3.40]31,5877,133not evaluable Very preterm (28 to 32 weeks) Ray - Beta-blockers, 2001 Al Khalaf - Beta-blockers (Controls unexposed, sick), 2022 Delteil - Beta-blockers, 2024 31.81[1.27; 2.59]9242,392not evaluable Extremely preterm (< 28 weeks) Delteil - Beta-blockers, 2024 13.37[1.04; 10.95]208414not evaluable Large for gestational age (weight) Mazkereth - Beta-blockers, 2019 11.85[0.61; 5.65]14153not evaluable Very low birth weight (< 1500g) Duan - Beta-blockers, 2018 16.89[6.09; 7.79]3,7324,847not evaluable Maternal consequences Caesarean Fidler - Oxprenolol, 1983 Rosenfeld - Pindolol, 1986 Cruickshank - Labetalol, 1991 Lydakis - Atenolol, 1999 Darcie - Atenolol, 2004 Ersboll - Beta-blockers (Controls unexposed, sick), 2014 Tanaka - Beta-blockers, 2016 Ishibashi - Beta-blockers, 2017 Gandjbakhch - Beta-blockers, 2018 Duan - Beta-blockers, 2018 Mazkereth - Beta-blockers, 2019 Xiang - Labetalol, 2020 Kubota - Beta-blockers, 2023 Delteil - Beta-blockers, 2024 Vaclavik - Beta-blockers, 2024 152.19[1.91; 2.51]123,0428,469probable Preeclampsia Lydakis - Atenolol, 1999 Bayliss - Atenolol, 2002 Orbach - Atenolol, 2013 Hoeltzenbein c - Bisoprolol, 2018 Duan - Beta-blockers, 2018 Xiang - Labetalol, 2020 Al Khalaf - Beta-blockers (Controls unexposed, sick), 2022 71.54[0.79; 3.00]4,8067,323not evaluable Assisted deliveries (forceps, vacuum, ...) Darcie - Atenolol, 2004 Duan - Beta-blockers, 2018 Mazkereth - Beta-blockers, 2019 Kubota - Beta-blockers, 2023 Delteil - Beta-blockers, 2024 50.82[0.70; 0.95]23,7155,961not evaluable Abruptio placentae (retroplacental hematoma) Ersboll - Beta-blockers (Controls unexposed, sick), 2014 Xiang - Labetalol, 2020 20.29[0.14; 0.61]41178not evaluable Postpartum hemorrhage Ersboll - Beta-blockers (Controls unexposed, sick), 2014 10.80[0.16; 4.12]851not evaluable Maternal death Xiang - Labetalol, 2020 10.99[0.02; 50.39]-127not evaluable Neonatal disorders Neonatal hypoglycemia Rosenfeld - Pindolol, 1986 Yassen - Acebutolol, 1992 Darcie - Atenolol, 2004 Ersboll - Beta-blockers (Controls unexposed, sick), 2014 Bateman - Beta-blockers, 2016 Mazkereth - Beta-blockers, 2019 Kumar - Beta-blockers, 2020 Xiang - Labetalol, 2020 Kayser - Metoprolol/bisoprolol, 2020 91.77[1.43; 2.19]2,43211,443not evaluable Low Apgar score (< 7) (at 5 min) Fidler - Oxprenolol, 1983 Sibai - Labetalol, 1990 Darcie - Atenolol, 2004 Orbach - Atenolol, 2013 Duan - Beta-blockers, 2018 Gandjbakhch - Beta-blockers, 2018 Mazkereth - Beta-blockers, 2019 72.33[1.47; 3.67]4,1765,295serious Neonatal medical care Ray - Beta-blockers, 2001 Thewissen - Labetalol (Controls unexposed, sick), 2017 Mazkereth - Beta-blockers, 2019 Xiang - Labetalol, 2020 Kayser - Metoprolol/bisoprolol, 2020 51.94[1.31; 2.88]619979serious Low Apgar score (< 7) (at 1 min) Darcie - Atenolol, 2004 Orbach - Atenolol, 2013 Duan - Beta-blockers, 2018 Gandjbakhch - Beta-blockers, 2018 Mazkereth - Beta-blockers, 2019 52.38[2.16; 2.61]23,0575,160not evaluable Neonatal bradycardia Fidler - Oxprenolol, 1983 Yassen - Acebutolol, 1992 Bateman - Beta-blockers, 2016 Mazkereth - Beta-blockers, 2019 Kayser - Metoprolol/bisoprolol, 2020 51.94[1.06; 3.55]62411,026serious Fetal distress Yassen - Acebutolol, 1992 Chan - Labetalol, 2010 Gandjbakhch - Beta-blockers, 2018 33.86[0.96; 15.42]2456not evaluable Low Apgar score (< 7) (NOS) Rosenfeld - Pindolol, 1986 Baard - Beta-blockers, 2020 Vaclavik - Beta-blockers, 2024 30.97[0.40; 2.33]32795not evaluable Neonatal death (< 28 days of life) Lieberman - Propranolol, 1978 Tanaka - Beta-blockers, 2016 Xiang - Labetalol, 2020 31.45[0.56; 3.81]18178not evaluable Neonatal disorders (as a whole) Ray - Beta-blockers, 2001 Chan - Labetalol, 2010 Kayser - Metoprolol/bisoprolol, 2020 31.93[1.02; 3.62]161428not evaluable Feeding difficulty Mazkereth - Beta-blockers, 2019 13.02[0.12; 74.72]1153not evaluable Jaundice / Icterus Chan - Labetalol, 2010 Xiang - Labetalol, 2020 22.85[1.60; 5.08]68156not evaluable Neonatal hypotension Yassen - Acebutolol, 1992 Xiang - Labetalol, 2020 28.24[2.61; 26.04]27135not evaluable Neonatal intracranial hemorrhage Thewissen - Labetalol (Controls unexposed, sick), 2017 11.00[0.13; 7.81]422not evaluable Very low Apgar score (< 5) (at 1 min) Sibai - Labetalol, 1990 Darcie - Atenolol, 2004 21.25[0.48; 3.23]19126not evaluable Low Apgar score (< 7) (at 10 min) Duan - Beta-blockers, 2018 12.50[1.86; 3.36]1,4764,847not evaluable Neonatal tachypnea Yassen - Acebutolol, 1992 19.80[0.44; 219.26]311not evaluable Long term consequences Child/Infant death (> 28 days of life) Gandjbakhch - Beta-blockers, 2018 10.69[0.07; 6.78]513not evaluable Intrauterine deaths Late intrauterine deaths (> 22 weeks) Lieberman - Propranolol, 1978 Fidler - Oxprenolol, 1983 Lydakis - Atenolol, 1999 Gandjbakhch - Beta-blockers, 2018 Kayser - Metoprolol/bisoprolol, 2020 Al Khalaf - Beta-blockers (Controls unexposed, sick), 2022 Delteil - Beta-blockers, 2024 71.70[0.81; 3.57]4634,206not evaluable Perinatal death Lieberman - Propranolol, 1978 Rosenfeld - Pindolol, 1986 Ray - Beta-blockers, 2001 Petersen - Beta-blockers, 2012 Orbach - Atenolol, 2013 51.84[1.28; 2.63]7,5183,026not evaluable Early intrauterine death (< 22 weeks) Fidler - Oxprenolol, 1983 Ishibashi - Beta-blockers, 2017 Hoeltzenbein c - Bisoprolol, 2018 Delteil - Beta-blockers, 2024 40.89[0.56; 1.41]9,0932,244not evaluable Intrauterine deaths (as a whole or unspecified) Xiang - Labetalol, 2020 Delteil - Beta-blockers, 2024 21.36[0.42; 4.37]10,147950not evaluable Elective/induced termination of pregnancy Hoeltzenbein c - Bisoprolol, 2018 10.80[0.40; 1.60]47339not evaluable Therapeutic terminations of pregnancy Delteil - Beta-blockers, 2024 11.11[0.61; 2.02]9511,813not evaluable Neuro-developmental disorders Cognitive developmental disorders/delay (3-6 years old) Chan - Labetalol, 2010 11.50[0.65; 3.47]-32not evaluable Language disorders/delay Chan - Labetalol, 2010 10.85[0.37; 1.96]-32not evaluable0.0100.01.0

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