Table 9.
Beta-blockers compared to other antihypertensive drugs or placebo in mothers with gestational hypertension.
| Certainty Assessment | Summary of Findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Participants (Studies)Follow-up |
Risk of Bias | Inconsistency | Indirectness | Imprecision | Publication Bias | Overall Certainty of Evidence | Study Event Rates (%) | Relative Effect (95% CI) |
Anticipated Absolute Effects | ||
| With Other Antihypertensive Drugs or Placebo | With Beta-Blockers | Risk with Other Antihypertensive Drugs or Placebo | Risk Difference with Beta-Blockers | ||||||||
| Bradycardia (Cohort studies) | |||||||||||
| 2,293,407 (3 observational studies) |
Serious a | Serious b | not serious | Serious c | strong association | ⨁⨁◯◯ Low |
11,669/2,282,318 (0.5%) | 175/11089 (1.6%) |
RR 2.10 (0.97 to 4.55) |
5 per 1000 |
6 more per 1000 (from 0 fewer to 18 more) |
| Bradycardia (Case control studies) | |||||||||||
| 45 cases 800 controls (5 observational studies) |
very serious d | very serious e | not serious | very serious f | none | ⨁◯◯◯ Very low |
45 cases 800 controls |
RR 1.86 (0.31 to 11.19) |
Low | ||
| 0 per 1000 |
0 fewer per 1000 (from 0 fewer to 0 fewer) |
||||||||||
| Bradycardia (RCTs) | |||||||||||
| 2013 (11 RCTs) |
very serious g | not serious | not serious | not serious | none | ⨁⨁◯◯ Low |
15/1017 (1.5%) | 38/996 (3.8%) |
RR 2.36 (1.33 to 4.18) |
15 per 1000 |
20 more per 1000 (from 5 more to 47 more) |
| Hypoglycemia (Cohort studies) | |||||||||||
| 2,374,957 (6 observational studies) |
Serious h | serious i | not serious | not serious | strong association | ⨁⨁⨁◯ Moderate |
29,954/2,362,830 (1.3%) | 620/12,127 (5.1%) |
RR 3.01 (2.79 to 3.25) |
13 per 1000 |
25 more per 1000 (from 23 more to 29 more) |
| Hypoglycemia (Case control studies) | |||||||||||
| 168 cases 416 controls (5 observational studies) |
very serious j | not serious i | not serious | Serious k | none | ⨁◯◯◯ Very low |
168 cases 416 controls |
RR 1.72 (1.33 to 2.22) |
Low | ||
| 0 per 1000 |
0 fewer per 1000 (from 0 fewer to 0 fewer) |
||||||||||
| Hypoglycemia (RCTs) | |||||||||||
| 2051 (12 RCTs) |
Serious l | not serious | not serious | serious c | none | ⨁⨁◯◯ Low |
57/1018 (5.6%) | 77/1033 (7.5%) |
RR 1.06 (0.79 to 1.41) |
56 per 1000 |
3 more per 1000 (from 12 fewer to 23 more) |
CI: confidence interval; RR: risk ratio. Explanations a All the studies had a moderate risk of overall bias. b I2 > 50%. c 95% CI crosses line of no effect. d The study with the highest weightage had a serious risk of overall bias. e I2 = 82%. f Very low event rates and 95% CI shows appreciable benefit and harm. g Most of the studies had a high risk of overall bias. h The study contributing to maximum weightage had a moderate risk of overall bias. i Though the I2 was large, it was due to differences between the small and large magnitude of effects. j Most of the studies had a serious to critical risk of overall bias. k Optimal information criterion (OIS) not satisfied due to a low event rate and sample size. l The studies with highest weightage had a high risk of overall bias or some concerns. ⨁◯◯◯: Very low, ⨁⨁◯◯: Low, ⨁⨁⨁◯: Moderate and ⨁⨁⨁⨁: High.