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Medications and More during pregnancy and breastfeeding

Propranolol

Selected References:

  • Bateman BT, et al. 2016. Late pregnancy β blocker exposure and risks of neonatal hypoglycemia and bradycardia. Pediatrics 138(3) pii:e20160731. 
  • Bauer et al. 1979. Propranolol in human plasma and breast milk. Am J Cardiol 43(4):860-862. 
  • Bratton S, et al. 2024. Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis. Journal of Perinatal Medicine. 52.8: 858-862. 
  • Davis RL, et al. 2011. Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy. Pharmacoepidemiol Drug Saf. 20(2):138-45.  Duan L, et al. 2017. b-Blocker exposure in pregnancy and risk of fetal cardiac anomalies. JAMA Intern Med
  • 177(6):885-887.  
  • Duan L, et al. 2018. Beta-blocker subtypes and risk of low birth weight in newborns. J Clin Hypertens 20(11):1603-1609. 
  • Firoz T, et al. 2014. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG 121(10):1210-1218. 
  • Fischer AJ, et al. 2021. Antiarrhythmic drugs – safety and efficacy during pregnancy. Herzschrittmacherther Elektrophysiol 32(2): 145-151. 
  • Freppel R, et al. 2024. Beta-blockers and breastfeeding: a real-life prospective study. Eur J Clin Pharmacol. 80(12):1937-1943.  
  • Halpern DG, et al. 2019. Use of medication for cardiovascular disease during pregnancy: JACC state-of-the-art review. Journal of the American College of Cardiology. 73.4: 457-476. 
  • Hutchinson S, et al. 2013. Use of common migraine treatments in breast-feeding women: A summary of recommendations. Headache 53(4):614-627.  
  • Joglar JA, et al. 2023. 2023 HRS expert consensus statement on the management of arrhythmias during pregnancy. Heart Rhythm. 20.10: e175-e264. Karlberg B, et al.
  • 1974. Excretion of propranolol in human breast milk. Aceta Pharmacol Toxicol 34(3):222-224. 
  • Lennestal R, et al. 2009. Maternal use of antihypertensive drugs in early pregnancy and delivery outcome, notably the presence of congenital heart defects in the infants. Eru J Clin Pharmacol 65(6):615-625. 
  • Manolis TA, et al. 2020. Cardiac arrhythmias in pregnant women: need for mother and offspring protection. Curr Med Res Opin 36(7)1225-1243. 
  • Moss HB, Procci WRR. 1982. Sexual dysfunction associated with oral antihypertensive medication: a critical survey of the literature. Gen Hosp Psych 4(2):121-129. 
  • Riant P, et al. 1986. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol 35(24):4579-4581. 
  • Rosen RC, et al. 1988. Beta-blocker effects on sexual function in normal males. Arch Sex Behav. 17(3):241-255. Ruys TP, et al. 2014. Cardiac medication during
  • pregnancy, data from the ROPAC. Int J Cardiol. 177(1):124-128.  
  • Salman M, et al. 2016. Erectile dysfunction: prevalence, risk factors, and involvement of antihypertensive drugs intervention. Trop J Pharm Res 15(4)869-876. 
  • Smith MT et al. 1983. Propranolol, propranolol glucuronide, and naphthoxylactic acid in breast milk and plasma. Ther Drug Monit. 5(1):87-93. 
  • Tanaka K, et al. 2016. Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. Circ J 80(10):2221-2226. Taylor EA, Turner P. 1981. Anti-hypertensive therapy with propranolol during pregnancy and lactation.  Postgrad Med J 57(669):427-430. 
  • Thorley KJ, McAinish J. 1983. Levels of the beta-blockers atenolol and propranolol in the breast milk of women treated for hypertension in pregnancy.  Biopharm Drug Dispos. 4(3):299-301. 
  • Turnstall ME. 1969. The effect of propranolol on the onset of breathing at birth. Br J Anaesth 41(9):792. 
  • Welzel T, et al. 2021. Intrauterine growth retardation in pregnant women with Long QT syndrome treated with beta-receptor blockers. Neonatology 118(4)406-415. 
  • Xie RH, et al. 2014. Association between labetalol use for hypertension in pregnancy and adverse infant outcomes. Eur J Obstet Gynecol Reprod Biol 175:124-128. 
  • Xie RH, et al. 2014. Beta-blockers increase the risk of being born small for gestational age or of being institutionalized during infancy. BJOG. 121(9):1090-1096. 
  • Yakoob MY, et al. 2013. The risk of congenital malformations associated with exposure to β-blockers in pregnancy: a meta-analysis. Hypertension 62(2):375-381. 

 

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